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目的:探讨微创经皮肾穿刺碎石术出血原因及防治措施。方法:回顾分析我科2008年10月至2013年10月通过微创经皮肾穿刺碎石术治疗的肾结石、输尿管上段结石患者临床资料共102例,其中出血患者5例,1例为术中出血,4例为术后继发性出血。结果:1例采用夹管、止血、输血等保守治疗,4例采用夹管、止血保守治疗,5例患者均痊愈出院。结论:微创经皮肾穿刺碎石术并发出血应以预防为主,准确穿刺定位及提高通道扩张技巧,可减少出血。经皮肾穿刺碎石术出血应根据不同的出血原因选择不同的处理方式,特别是对经皮肾穿刺碎石术开展时间尚短的医院更应在经皮肾穿刺碎石术出血较多时及时终止手术,保证安全前提下再行二期清石。
Objective: To investigate the causes and prevention measures of minimally invasive percutaneous nephrolithotomy. Methods: A retrospective analysis of our department from October 2008 to October 2013 by minimally invasive percutaneous nephrolithotomy lithiasis treatment of upper ureteral calculi in patients with clinical data of 102 cases, including bleeding in 5 cases, 1 case of surgery Bleeding, 4 cases of postoperative secondary bleeding. Results: One case received conservative treatment such as pinch tube, hemostasis, and blood transfusion. Four cases were treated by pinch tube and conservative treatment of hemostasis. All five patients were cured and discharged. Conclusion: minimally invasive percutaneous nephrolithotomy with bleeding should be based on prevention, accurate puncture positioning and improve channel expansion skills, can reduce bleeding. Percutaneous renal lithotripsy bleeding should be based on different causes of bleeding to choose a different treatment, especially for percutaneous nephrolithotomy lithotripsy surgery is also short time in the percutaneous nephrostomy bleeding should be more timely Terminate the operation, to ensure safety under the premise of the second phase of stone.