[1]许开良,程帆,饶婷,等.1555例“经肾盏穹窿-盏颈轴线两步穿刺法”建立经皮肾通道碎石取石术出血原因分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(01):3-7.[doi:10.3877/cma.j.issn.1674-3253.2018.01.002 ]
　Xu Kailiang,Cheng Fan,Rao Ting,et al.Risk factors for hemorrhage during and after percutaneous nephrolithotomy with axis positioning of two steps punctures among 1555 patients[J].,2018,12(01):3-7.[doi:10.3877/cma.j.issn.1674-3253.2018.01.002 ]
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1555例“经肾盏穹窿-盏颈轴线两步穿刺法”建立经皮肾通道碎石取石术出血原因分析()
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中华腔镜泌尿外科杂志(电子版)[ISSN:1006-6977/CN:61-1281/TN]

卷:
12卷
期数:
2018年01期
页码:
3-7
栏目:
临床研究
出版日期:
2018-01-31

文章信息/Info

Title:
Risk factors for hemorrhage during and after percutaneous nephrolithotomy with axis positioning of two steps punctures among 1555 patients
作者:
许开良; 程帆; 饶婷; 阮远; 余伟民; 袁润; 张孝斌
430060 武汉大学人民医院泌尿外科
Author(s):
Xu Kailiang;  Cheng Fan;  Rao Ting;  Ruan Yuan;  Yu Weiming;  Yuan Run;  Zhang Xiaobin.
Department of Urology, Renmin Hospital of Wuhan University, Wuhan 430060,China
关键词:
经皮肾镜;  通道;  出血;  轴线;  风险因素
DOI:
10.3877/cma.j.issn.1674-3253.2018.01.002
摘要:
目的 探讨在超声引导下“经肾盏穹窿- 盏颈轴线两步穿刺法”建立经皮肾通道碎石取石术中、术后出血的原因。方法 回顾性分析2013 年6 月至2016 年6 月武汉大学人民医院行经皮肾镜碎石取石术（PCNL）治疗上尿路结石的1 555 例患者的临床资料。通过对年龄、性别、体质量指数、结石大小、结石类型、肾脏集合系统结构、肾脏积水程度、是否合并高血压及糖尿病，通道大小、通道数量、碎石工具等相关因素进行单变量及Logistic 回归分析，探讨PCNL 出血的可能因素。结果 1 555 例手术均由同一名主刀医师顺利完成，术中或术后进行输血治疗的患者有56 例，输血率为3.6％。其中11 例出血的患者因保守治疗效果不佳，进一步行超选择性栓塞治疗。在单变量及Logistic 回归分析中发现结石类型（P<0.001，OR=-1.963）、结石大小（P=0.009，OR=1.687）、通道数量（P<0.001，OR=2.121）、肾脏集合系统结构（P<0.001，OR=2.128）以及合并糖尿病（P<0.001，OR=1.593）是影响手术出血主要因素。结论 经“ 肾盏穹窿- 盏颈轴线两步穿刺法”建立PCNL 通道是一项安全，有效的技术。术中、术后出血与合并有糖尿病史、肾脏集合系统结构异常、结石负荷过大（尤其鹿角形结石）及术中建立多通道等因素有关。

参考文献/References:

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备注/Memo

备注/Memo:
通讯作者：程帆，Email: 646064793@qq.com
更新日期/Last Update: 2018-02-25