经皮肾镜取石术出血影响因素探讨

Influence factors of hemorrhage in percutaneous nephrolithotomy

目的：探讨经皮肾镜取石术出血的影响因素及其防治措施。方法：回顾性分析12例经皮肾镜取石术出血病人的临床资料。结果：12例患者有7例发生于术中,调整或关闭peel-away鞘5~10 min后,5例好转继续手术,2例仍有出血及时终止手术；5例发生于术后,均予以夹闭肾造瘘管及止血治疗,2例予以超选择性肾动脉栓塞治疗,所有患者均治愈出院。结论：出血是经皮肾碎石取石术常见的并发症,受多种因素影响,术前充分准备、手术规范操作和及时、正确的诊断和处理是降低出血发生的有效措施。

Objective：To explore the influence factors of hemorrhage in percutaneous nephrolithotomy and prevention meas-ures. Methods：To analyze the clinical data of 12 patients with hemorrhage in percutaneous nephrolithotomy retrospectively. Results：7 patients had bleeding during the operation,5 of them went on with operation after adjusting or blocking the peel-away sheath about 5-10 minutes,2 of them were stopped operation for still bleeding. 5 patients had hemorrhage after the operation. 2 were treated with clipping renal fistula and hemostatic, and 3 were treated with super selective renal artery embolization. All patients were cured. Conclusion：Hemorrhage is common complication of percutaneous nephrolithotripsy,and it is affected by various factors,so fully preparation before operation,standard operation and correct diagnosis and treatment are effective measures to reduce the bleeding.