等离子柱状电极在经皮肾镜取石术中通道止血的应用

Application of bipolar plas makinetic technique with band-form electrode in percutaneous nephro- lithotomy complicated arterial hemobilia

目的探讨等离子柱状电极电凝止血在经皮肾镜取石术（PCNL）中通道止血的方法及·临床价值。方法回顾性分析2009年8月至2012年9月54例经皮肾镜取石术中动脉出血应用等离子柱状电极电凝止血的临床资料。结果54例患者均应用等离子柱状电极电凝止血成功，均未出现术后早期或迟发严重出血，无中转开放手术或行高选择性肾动脉栓塞术。20例术后24h出现一过性肉眼血尿，未影响生命体征。6例术后5d出院，其余均术后7d出院。结论等离子柱状电极电凝止血能有效应用于PCNL穿刺通道动脉止血，效果确切，该方法简便易行，有利于PCNL手术的推广，是一种有效、安全的止血方法。

Objective To investigate the efficacy of bipolar band-form electrode on hemostasis in percutaneous nephrolithotomy（PCNL）. Methods From August 2009 to September 2012, the clinical data of 54 cases, who were given bipolar plas makinetic technique with band-form electrode for hemostasis in percutaneous nephrolithotomy because of arterial hemobilia. Results Successful hemostasis was achieved in all of the 54 patients, indwelling ureteral stents and nephrostomy tubes, no severe postoperative hemor- rhage, 20 cases showed mild hematuria without clot in urine and recovered spontaneously in 24 hours. Six cases were discharged 5 days after operation, the other cases were discharged 7 days after operation, with- out turning to open surgery or performing nephrectomy emergently, or using digital substraction angiography （DSA） highly selective renal artery embolization. Conclusions The technique of using active cauteriza- tion of renal tract in percutaneous nephrolithotomy with plas makinetic superpulse generator electrode is ef- fective and safe. It is safe, feasible and effective for hemostasis, and conductive to popularizing PCNL.