微创经皮肾镜碎石取石术的出血原因与防治

Minimally invasive percutaneous nephrolithotomy stone lithotripsy causes and prevention of bleeding

目的:对微创经皮肾镜取石术后发生出血症状的原因和防治手段进行分析,总结出经皮肾镜碎石取石术后出血的防治方法。方法:随机抽取2005年4月～2009年4月这4年时间在本院就诊的肾结石患者24例,均为在进行微创经皮肾镜取石术中或术后出现出血的患者,对这些病例进行分析,总结导致出血的原因和防治的方法。结果:研究结果显示,在抽样中的24例患者中,19例患者经过应用止血药、造瘘管夹闭、造瘘管牵引等治疗其出血症状得到有效控制;5例无效的患者采用超选择性栓塞治疗后血尿逐渐消失康复;对所有患者随访2年,其肾功能状态良好。结论:术后出血是经皮肾镜碎石取石术治疗后的一种较常见的并发症,处理不当可能导致严重后果,应用止血药、夹闭造瘘管、造瘘管牵引、超选择性肾动脉栓塞等方法对该并发症有确切的治疗效果。经皮肾镜碎石取石术后出血时及时选择应用上述止血措施对于提高该病患者的治愈率,缩短患者治疗时间,促进患者康复,有着十分积极的意义。

Objective：To analyze the affect of minimally invasive percutaneous nephrolithotomy stone postoperative bleeding.Methods：Randomly selected in 24 cases from April 2005 to April 2009 in our hospital,analyzed cases that cluded the reasons leading bleeding and prevention.Results：The study showed that in the 24 patients sampling,19 patients through the application of hemostatic agents,fistula occlusion,fistula treatment such as traction control symptoms of bleeding;five cases of ineffective treatment of patients with super-selective embolization hematuria gradually disappear after rehabilitation;All patients were followed for two years on renal function in good condition.Conclusion：Postoperative bleeding is percutaneous nephrolithotomy stone lithotripsy treatment of a relatively common complication of improper handling may lead to serious consequences,the application of hemostatic agents,fistula occlusion,fistula traction,super-selective renal artery embolization other methods of treatment of the complications of the exact effect.Percutaneous nephrolithotomy stone bleeding to stop bleeding in time choose to apply the above measures for improving the cure rate of patients with the disease,reduce patient treatment time,to promote the rehabilitation of patients,has a very positive meaning.