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目的:探讨微创经皮肾穿刺取石(mPCNL)术中术后出现严重并发症的发生情况及处理措施。方法:回顾性分析mPCNL治疗上尿路结石2 470例患者的临床资料。结果:2 470例患者接受mPCNL.共发生严重并发症184例,占7.45%。因穿刺失败、工作通道丢失及术中渗血等导致手术进展困难32例,占1.29%,继发出血78例,占3.16%,冲洗液外渗17例,占0.69%,炎症反应综合征48例,占1.94%,临近脏器损伤9例,占0.36%。各种并发症导致开放手术7例,肾切除5例,选择性肾动脉栓塞23例。结论:微创经皮肾穿刺取石术也有一定的并发症发生,了解并发症发生的原因和特点,加强预防和有效治疗,是保证安全的主要措施。
Objective: To investigate the occurrence and treatment of serious postoperative complications in minimally invasive percutaneous nephrolithotomy (mPCNL). Methods: A retrospective analysis of mPCNL treatment of upper urinary tract stones in 470 cases of patients with clinical data. Results: A total of 2 470 patients received mPCNL, with a total of 184 serious complications (7.45%). There were 32 cases (1.29%), secondary bleeding occurred in 78 cases (3.16%), flushing fluid extravasation in 17 cases (0.69%), inflammatory response syndrome (48%) due to failure of puncture, loss of working channel and intraoperative bleeding. Cases, accounting for 1.94%, 9 cases of organ damage near, accounting for 0.36%. Various complications led to open surgery in 7 cases, 5 cases of nephrectomy, selective renal artery embolism in 23 cases. Conclusion: The minimally invasive percutaneous nephrolithotomy also has certain complications. To understand the causes and characteristics of complications and to enhance prevention and effective treatment are the main measures to ensure safety.