CAJ | 학술논문

目的：探讨经皮肾镜取石术(PCNL)术后肾脏严重出血原因及临床有效处理及预防方法。方法9例上尿路结石采用PCNL术中及术后出血患者，分别采用超选择性肾动脉栓塞(SRAE)及夹闭肾造瘘管等方法处理，观察临床效果。结果6例行SRAE治疗，单纯夹闭肾造瘘管后产生血块自行止血2例， F16气囊导尿管压迫止血1例，术后继发出血病例均得到有效控制。结论PCNL出血并发症无法完全避免，但谨慎选择合理的穿刺通道及术中熟练的操作技巧等可大大减少出血几率。超选择性肾动脉栓塞处理PCNL并发出血疗效确切。
목적：탐토경피신경취석술(PCNL)술후신장엄중출혈원인급림상유효처리급예방방법。방법9례상뇨로결석채용PCNL술중급술후출혈환자，분별채용초선택성신동맥전새(SRAE)급협폐신조루관등방법처리，관찰림상효과。결과6례행SRAE치료，단순협폐신조루관후산생혈괴자행지혈2례， F16기낭도뇨관압박지혈1례，술후계발출혈병례균득도유효공제。결론PCNL출혈병발증무법완전피면，단근신선택합리적천자통도급술중숙련적조작기교등가대대감소출혈궤솔。초선택성신동맥전새처리PCNL병발출혈료효학절。
Objective To investigate the causes and clinical methods for treatment and prevention of severe renal hemorrhage after percutaneous nephrolithotomy (PCNL).Methods There were 9 upper urinary tract calculi patients with hemorrhage during and after PCNL, and they respectively received super-selective renal artery embolization (SRAE) and occlusion nephrostomy tube. Their clinical effects were observed.Results There were 6 cases undergoing SRAE, 2 cases with blood clot after occlusion nephrostomy tube, 1 case undergoing compression hemostasis by F16 aerocyst urethral catheter. All cases with postoperative secondary hemorrhage received effective control.Conclusion Hemorrhage complications of PCNL cannot be completed refrained, while rational choice of puncture channel and skilled operation can remarkably reduce hemorrhage rate. Super choice arterial embolization provides precise effect in treating hemorrhage after PCNL.