[1]杨伟忠 石崇军 蔡华戈 张小悦.微创经皮肾镜取石术并发严重出血的诊治[J].中华腔镜泌尿外科杂志(电子版),2014,(04):278-281.[doi:10.3877/cma.j.issn.1674-3253.2014.04.011 ]
　Yang Weizhong,Shi Chongjun,Cai Huage,et al.Diagnosis and treatment for severe hemorrhagic following minimally invasive percutaneous nephrolithotomy[J].,2014,(04):278-281.[doi:10.3877/cma.j.issn.1674-3253.2014.04.011 ]
点击复制

微创经皮肾镜取石术并发严重出血的诊治()
分享到：

中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
期数:
2014年04期
页码:
278-281
栏目:
临床研究
出版日期:
2014-08-31

文章信息/Info

Title:
Diagnosis and treatment for severe hemorrhagic following minimally invasive percutaneous nephrolithotomy
作者:
杨伟忠 石崇军 蔡华戈 张小悦
516002广东，惠州市第三人民医院泌尿外科
Author(s):
Yang Weizhong;  Shi Chongjun;  Cai Huage;  Zhang Xiaoyue.
Department of Urology, the Third People′s Hospital of Huizhou, Guangdong 516002, China
关键词:
经皮肾镜; 出血; 保守治疗; 动脉栓塞; 肾切除
DOI:
10.3877/cma.j.issn.1674-3253.2014.04.011
摘要:
目的 探讨微创经皮肾镜取石术（ MPCNL）并发严重出血的诊治方法。方法 回顾性分析 2004年 1月至 2013年 10月我院实施的 1003例微创经皮肾镜取石术并发严重出血的 29例患者资料，并统计分析经传统保守治疗及改进保守治疗病例的成功率。结果 13例（ 44.8%）经保守治疗治愈， 14例（ 48.3%）行超选择性肾动脉栓塞术止血成功，经改进的保守治疗组成功率高于传统保守治疗组，差异具有统计学意义（ P<0.05）。2例（ 6.9%）患者最终行患肾切除术。无一例死亡。结论 MPCNL并发严重出血在选择性肾动脉栓塞术之前给予的干预治疗往往有效，如判断为静脉性出血经保守治疗无效时应果断行肾切除术。

参考文献/References:

[1] Monga M, Oglevie S. Minipercutaneous nephrolithotomy [J]. J Endourol, 2000, 14(5): 419-421.
[2] Li X, He Z, Wu K, et al. Chinese minimally invasive percutaneous nephrolithotomy: the Guangzhou experience[J]. J Endourol, 2009, 23(10): 1693-1697.
[3] 李逊.微创经皮肾穿刺取石术 (MPCNL)[J].中国现代手术学杂志, 2003, 7(5): 338-344.
[4] Lai D, He Y, Dai Y, et al. Combined minimally invasive percutaneous nephrolithotomy and retrograde intrarenal surgery for staghorn calculi in patients with solitary kidney[J]. PLoS One, 2012, 7(10): e48435.
[5] 杨伟忠, 何平胜. 多通道微创经皮肾镜治疗复杂性肾结石[J]. 中国微创外科杂志, 2012, 12(3): 236-238.
[6] Tsujimoto Y, Shima H, Mori Y, et al. Destruction of renal parenchyma at percutaneous nephrolithotripsy; experimental study [J]. Hinyokika Kiyo, 1989, 35(7): 1099-1103.
[7] 邱剑光, 张晓阳, 王德娟, 等. Gyrus 等离子柱状电极应用于经皮肾镜术穿刺通道主动止血的临床研究[J/CD]. 中华腔镜泌尿外科杂志: 电子版, 2010, 4(1): 13-16.
[8] 王宇雄, 李逊, 吴开俊, 等. 经皮肾穿刺取石术并发大出血的处理[J]. 微创医学, 2006, 1(1): 11-13.
[9] 刘辉, 刘建强, 张志坚. 冰盐水灌胃对非曲张静脉所致上消化道大出血疗效观察. 山东医药, 2009, 49(43): 12.
[10] Jinga V, Dorobat B, Youssef S, et al. Transarterial embolization of renal vascular lesions after percutaneous nephrolithotomy [J].Chirurgia (Bucur), 2013, 108(4): 521-529.
[11] Goel A, Aron M, Gupta NP, et al. Relook percutaneous nephrolithotomy: a simple technique to re-enter the pelvicalyceal system[J]. Urol Int, 2003, 71(2): 143-145.
[12] Rastinehad AR, Andonian S, Smith AD, et al. Management of hemorrhagic complications associated with percutaneous nephrolithotomy[J]. J Endourol, 2009, 23(10): 1763-1767.

相似文献/References:

[1]梁卓寅,曾国华,吴文起,等.经皮肾穿刺术后出血原因和介入栓塞治疗[J].中华腔镜泌尿外科杂志(电子版),2007,(02):81.
　LIANG Zhuo-yin,ZENG Guo-hua,WU Wen-qi,et al.The hemorrhage after PCNL: the reason and the treatment by Super-selective renal arterial embolization[J].,2007,(04):81.
[2]徐刚,张心男.前列腺增生经尿道电切术后早期出血再手术原因分析[J].中华腔镜泌尿外科杂志(电子版),2008,(02):151.
　XU Gang,ZHANG Xin-nan.Analysis of the reasons of re-surgery for early bleeding after TURP[J].,2008,(04):151.
[3]林红,李晓玲,张学红.复杂性肾结石超声引导经皮肾镜碎石取石术的护理[J].中华腔镜泌尿外科杂志(电子版),2008,(02):155.
　LIN Hong-yun,LI Xiao-ling,ZHANG Xue-hong.Nursing study of percutaneous nephrolithotripsy with pneumatic and ultrasonic power under B-type ultrasound guidance for treatment of complicated renal calculi[J].,2008,(04):155.
[4]韩杰,黄群联,程庆水,等.经皮肾镜超声碎石术治疗上尿路结石[J].中华腔镜泌尿外科杂志(电子版),2009,(02):13.
　HAN Jie,HUANG Qun-lian,CHEN Qing-shui,et al.Treatment of upper urinary tract stones by ultrasound guided lithotripsy in percutaneous nephrolithotomy(report of 120 cases)[J].,2009,(04):13.
[5]邓景球,李宋荣,史向民,等.经皮肾取石和输尿管镜碎石治疗嵌顿性输尿管上段结石的疗效比较[J].中华腔镜泌尿外科杂志(电子版),2009,(03):222.
　DENG Jing-qiu,LI Song-rong,SHI Xiang-min,et al.A comparative study of percutaneous nephrolithotomy and ureteroscopic lithotripsy for the treatment of impacted upper ureteral stones[J].,2009,(04):222.
[6]王锐,石洪波,门晓炜,等.改良负压吸引经皮肾镜钬激光碎石71 例报告[J].中华腔镜泌尿外科杂志(电子版),2009,(03):225.
　WANG Rui,SHI Hong-bo,MEN Xiao-wei,et al.Improvement to Holmium laser with percutaneous nephrolithotripsy (report of 71 cases)[J].,2009,(04):225.
[7]刘建和,李炯明,陈戬,等.局麻下微通道经皮肾镜取石术[J].中华腔镜泌尿外科杂志(电子版),2009,(03):237.
　LIN Jian-he,LI Jiong-ming,CHENG Jian,et al.Minimally invasive percutaneous nephrolithotomy under local anaesthesia[J].,2009,(04):237.
[8]赵海涛,刘致中,黄学宏.微造瘘经皮肾镜气压弹道碎石术治疗肾及输尿管上段结石[J].中华腔镜泌尿外科杂志(电子版),2010,(01):40.
　ZHAO Hai-tao,LIU Zhi-zhong,HUANG Xue-hong.Minimally invasive percutaneous pneumatic lithotripsy for the treatment of kidney and proximal ureteral calculi[J].,2010,(04):40.
[9]吴荣佩,彭振鹏,李晓飞,等.CT三维视频影像在鹿角形肾结石腔内治疗中的应用[J].中华腔镜泌尿外科杂志(电子版),2010,(03):180.
　WU Rong-pei,PENG Zhen-peng,LI Xiao-fei,et al.The application of three dimensional CT movie image in endoscopic treatment of staghorn renal calculi[J].,2010,(04):180.
[10]王德娟,邱剑光,方友强,等.小儿上尿路多发结石的微创手术处理[J].中华腔镜泌尿外科杂志(电子版),2010,(03):193.
　WANG De-juan,QIU Jian-guang,FANG You-qiang,et al.Preliminary experience with minimally invasive endourological management of multiple upper urinary tract calculi in children[J].,2010,(04):193.
[11]张智,秦卫军,袁建林,等.经皮肾镜碎石取石术严重出血的相关因素分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(03):194.[doi:10.3877/cma.j.issn.1674-3253.2018.03.012 ]
　Zhang Zhi,Qin Weijun,Yuan Jianlin,et al.Factors related to severe hemorrhage caused by percutaneous nephrolithotomy[J].,2018,12(04):194.[doi:10.3877/cma.j.issn.1674-3253.2018.03.012 ]
[12]党博文,米华.经皮肾镜碎石取石术并发出血的原因及防治[J].中华腔镜泌尿外科杂志(电子版),2018,12(03):214.[doi:10.3877/cma.j.issn.1674-3253.2018.03.017 ]

备注/Memo

备注/Memo:
通讯作者：杨伟忠，Email：vg-yang@163.com
更新日期/Last Update: 2014-08-25