微创经皮肾镜取石术出血原因及防治

微创经皮肾镜取石术出血原因及防治

武英杰;廖松柏;李学德;于永刚;樊胜海

【期刊名称】《现代泌尿外科杂志》

【年(卷),期】2011(016)001

【摘要】Objective T o discuss the cause and management of bleeding during mini-percutaneous nephrolithotomy (MPCNL) for calculi. Methods The clinical data of 1 367 bleeding case with calculi treated under MPCNL were analysed retrospectively. Results In 1367 patients,16 cases hemoglobin drop exceeded 60 g/L,46 cases' drop was between 30～60 g/L,and 1 306 cases' drop was ＜30 g/L. The reasons of the 62 patients whose hemoglobin drop exceeded 30 g/L were diverse. 26 patients were bleeding when the percuan0teous approach was set up,13 when ureterosopic operation was performed. 23 patients bled because of infection and renal inadequacy. 17 patients were cured conservatively without secondary bleeding, six patients underwent angiography and subsequent hyperselective embolization,and 1 patient turned to nephrectomy. Conclusions The main causes of bleeding during MPCNL are the establishment of percutaneous passage,incorrect operational procedure and patients' hemorrhagic tendency. Suitable opportunity for operation, standardized operational procedure and promp management could lessen the complication of bleeding during MPCNL.%目的探讨微创经皮肾镜取石术(MPCNL)并发出血的原因及临床处理.