mPCNL并发出血的原因及防治(1)
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[摘要] 目的:总结微创经皮肾镜取石(mPCNL)术中、术后出血的发生原因及其预防和处理方法。方法:回顾性分析本院2005年7月～2009年10月57例次mPCNL术并发术中、术后出血患者的临床资料。结果:本组患者并发术中出血43例,其中38例经处理出血停止,继续手术,5例活动性出血,予放置肾造瘘管,改行二期mPCNL;术后出血14例,其中8例经夹闭造瘘管,绝对卧床及使用止血药后出血停止,3例经穿刺窦道Foley's管球囊压迫止血后成功止血,2例行介入治疗栓塞出血血管,1例予缝扎造瘘口2针后出血停止。结论:mPCNL是一种安全、有效的微创手术,但有可能术中、术后出现严重出血的并发症,预防和处理的关键为合理选择患者、操作轻柔、严密观察病情、及时恰当处理。
[关键词] 微创经皮肾镜取石;出血;原因;防治
[中图分类号] R364.2+5 [文献标识码]A [文章编号]1674-4721(2010)05(a)-037-03
The mPCNL erupts the reason and prevention and cure of issue of blood
HUANG Zongmou,WEN Tianfen,ZHI Qiming,SU Zongming
(Department of Urolory, People's Hospital of Huaiji County,Guangdong Province,Huaiji 526400,China)
[Abstract] Objective: Topurpose Tally up tiny reason and its treatment for creating the occurrence that is bled after taking the stone(mPCNL) in, the Shu by the skin kidney mirror. Methods: Look back sex analysis I hospital July, 2005 the 57 cases mPCNLs bleed the clinical data of case after erupting the Shu in, the Shu to October, 2009. Results: This sufferer erupts to bleed in the 43 cases, 38 among those examples were stopped by processing issue of blood, continue surgical operation, 5 movable sex bleed to placing a kidney to build to hug a tube and change profession 2 mpcnls; The bleeded behind 14, 8 among those examples through clip to shut to build to hug a tube, absolutely lie bed and used to bleed to stopped after stopping bleeding the medicine, 3 through wear to stab a Dou way Foley'the s tube ball bag the oppression successfully stopped bleeding after stopping bleeding, 2 routine get involved to cure clots of issue of blood blood vessel, 1 to sew firm build a Lou 2 needles behind bleed to stop. Conclusion: The mPCNL is a kind of safety, effectively tiny create surgical operation, but probably in, the Shu appear the complications of serious issue of blood behind, the key to prevention and processing handles for reasonable choice sufferer, operating a light and soft and tight observation condition, fitting in time.
[Key words] Mpcn;Bleed;Reason;Prevent and cure
2001年12月～2005年3月本院实施微创经皮肾镜取石术(mPCNL)1 032例次,并发出血57例,对术中术后出血的原因及其预防、处理方法进行了探讨。现报道如下:
1资料与方法
1.1一般资料
本组mPCNL术并发出血患者共57例,男36例,女21例,年龄15～68岁,平均40 ......
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