微创经皮肾穿刺取石术并发出血的治疗体会

The experience in treatment of bleeding after mini-percutaneous nephrolithotomy

目的探讨微创经皮肾穿刺取石术并发出血的治疗体会。方法回顾和分析2001年2月～2006年5月应用微创经皮肾穿刺取石术治疗上尿路结石3910例中出现大出血的20例资料。结果20例中19例治愈（16例行介入栓塞治疗，2例采用输血和导管压迫止血等保守治疗，1例行患肾切除术）。但还有1例经上述治疗无效，最后并发DIC死亡。结论出血是微创经皮肾穿刺取石术最常见和最主要的并发症。术中细致操作，术后细致观察，及时采取相应治疗措施，患者的手术安全性一定会得到很大提高。

Objective To investigate the treatment of hemorrhage after mini - percutaneous nephrolithotomy. Method From February 2001 to May 2006, 20 clinical data of severe bleeding were retrospectively analysed in 3910 cases of mini - percutaneous nephrulithotomy in treatment of upper urinary calculi. Results In 20 cases, 19 were successfully treated, in which 2 patients can be treated with expectant treatment （transfusion and catheter compression）, 16 cases were rendered with super -selective arterial embolization; 1 case with nephrectomy; 1 case wsa suffered from DIC and died. Conclusions The most familiar complication of mini - peroutaneous nephrolithotomy is bleeding. If only be more carefully and try the right way in time, the safety of the operation must be increased.