CAJ | 학술논문

目的：探讨微创经皮肾镜碎石术（percutaneous nephrolithotomy, PCNL）严重肾出血护理对策。方法回顾性分析南昌大学第一附属医院2003年1月至2010年9月期间接受PCNL术严重肾出血接受肾动脉造影患者27例的临床资料，总结严重肾出血的护理对策和体会。结果27例出血患者均在局部麻醉下行选择性肾动脉造影及栓塞治疗，24例出血患者行选择性肾动脉栓塞止血，3例出血停止患者行两次选择性肾动脉栓塞止血，1例患者因孤立肾行DSA引起短暂性肾功能不全，连续行血液透析7 d后，肾功能恢复。结论 PCNL术后并发大出血是严重的并发症之一，如处理不当或不及时，将导致肾切除，严重时会导致患者生命危险。 PCNL术严重肾出血正确的治疗方法和护理对策能够降低患者死亡风险，有利于PCNL术的展开。
목적：탐토미창경피신경쇄석술（percutaneous nephrolithotomy, PCNL）엄중신출혈호리대책。방법회고성분석남창대학제일부속의원2003년1월지2010년9월기간접수PCNL술엄중신출혈접수신동맥조영환자27례적림상자료，총결엄중신출혈적호리대책화체회。결과27례출혈환자균재국부마취하행선택성신동맥조영급전새치료，24례출혈환자행선택성신동맥전새지혈，3례출혈정지환자행량차선택성신동맥전새지혈，1례환자인고립신행DSA인기단잠성신공능불전，련속행혈액투석7 d후，신공능회복。결론 PCNL술후병발대출혈시엄중적병발증지일，여처리불당혹불급시，장도치신절제，엄중시회도치환자생명위험。 PCNL술엄중신출혈정학적치료방법화호리대책능구강저환자사망풍험，유리우PCNL술적전개。
Objective To investigate the nursing strategies for severe renal hemorrhage in minimally invasive percutaneous nephrolithotomy (PCNL). Methods Clinical data of 27 patients with severe renal hemorrhage after PCNL who underwent renal digital subtraction angiography (DSA) in the First Affiliated Hospital of Nanchang University between January 2003 and September 2010 were analyzed retrospectively. The strategies and experiences of nursing for severe renal hemorrhage were summarized. Results Among the 27 patients, selective renal DSA was performed under local anesthesia in 24, and selective renal artery embolization was performed twice under local anesthesia in 3. In addition, transient renal insufficiency occurred in 1 patient due to DSA. However, this patient had renal function recovery after 7 days of continuous hemodialysis. Conclusion Severe renal hemorrhage is a complication of PCNL. Improper or untimely treatment may result in nephrectomy and even life-threatening event. the correct treatment methods and nursing strategies can reduce the risk of death and contribute to the performance of PCNL in patients with severe renal hemorrhage.