摘要
目的探讨经皮肾镜取石术(PCNL)发生严重出血的相关危险因素.方法回顾性分析2018年1月至2019年12月在本院行PCNL治疗的211例患者的临床资料.采用lo-gistic回归分析患者的年龄、糖尿病、肾手术史、鹿角形结石、肾积水程度、穿刺位置、手术时间、通道大小、通道数与PCNL发生严重出血的相关性.结果发生严重出血患者18例,发生率为8.5%.单因素分析结果显示合并糖尿病、既往肾手术史、鹿角形结石、手术时间≥120 min、多通道手术者是PCNL发生严重出血的影响因素(均P<0.05);多因素logistic回归分析结果显示合并糖尿病、鹿角形结石、多通道手术者、手术时间≥120 min是PCNL发生严重出血的危险因素(均P<0.05).结论患者合并糖尿病、鹿角形结石、行多通道手术、手术时间≥120 min均能增加PCNL发生严重出血的风险.术前调整好患者血糖,尽量缩短手术时间,对鹿角形结石及多通道手术的患者采取联合软镜手术,提高手术者经验可能是减少出血的重要措施.
Objective To investigate the risk factors of severe bleeding after percutaneous nephrolithotomy(PCNL).Methods The clinical data of 211 patients who underwent PCNL from January 2018 to December 2019 were retrospectively analyzed.Logistic regression analysis was conducted to analyze the correlation between age,diabetes,history of renal surgery,staghorn stones,degree of hydronephrosis,puncture location,operation time,channel size and channel number on severe bleeding in PCNL.Results Severe bleeding occurred in 18 patients(8.5%).Univariate analysis showed that patients with diabetes mellitus,previous renal operation history,staghorn stones,operation tim≥120 min and multi-channel operation were the influential factors for severe bleeding in PCNL(all P<0.05).Multivariate logistic regression analysis showed that patients with diabetes mellitus,staghorn stones,multi-channel surgery and operation time≥120 min were risk factors for severe bleeding in PCNL(all P<0.05).Conclusions Patients with diabetes mellitus,staghorn stones,multi-channel surgery,and operation time≥120 minutes can increase the risk of severe bleeding.Adjusting the patient's blood sugar well before operation,shortening the operation time as much as possible,adopting combined flexible endoscopic surgery for patients with staghorn stones and multi-channel surgery,and improving the operators experience may be important measures to reduce bleeding.
作者
朱敬波
张超
李清华
陈红兵
李波
Zhu Jingbo;Zhang Chao;Li Qinghua;Chen Hongbing;Li Bo(Department of Urology,Hefei First Peoples Hospital,Hefei 230061,China)
出处
《国际泌尿系统杂志》
2022年第4期659-662,共4页
International Journal of Urology and Nephrology
关键词
肾结石
输尿管结石
肾造口术
经皮
出血
Kidney Calculi
Ureteral Calculi
Nephrostomy,Percutaneous
Hemorrhage