中国社区医师
中國社區醫師
중국사구의사
Chinese Community Doctors
2015年
13期
37-38
,共2页
经皮肾镜碎石术%肾结石%大出血
經皮腎鏡碎石術%腎結石%大齣血
경피신경쇄석술%신결석%대출혈
Percutaneous nephrolithotomy lithotripsy%Kidney stones%Bleeding
目的:探究经皮肾镜碎石术后大出血的原因及防治措施。方法:2010年1月-2014年9月收治行经皮肾镜碎石术后大出血患者21例,分析造成患者出现术后大出血的原因,并对原因进行统计学分析,找出可能引起大出血发生率增大的因素,对出血的预防与控制提供临床参考,并对出血患者进行介入栓塞止血的临床效果进行分析及讨论。结果:21例患者术后出血量800~2700 mL,平均(1200±680)mL。所有患者出血后,均先以扩容、输血、局部压迫止血、药物止血、闭管等保守治疗进行止血,出血情况得到控制10例(47.62%),经紧急介入栓塞治疗后止血11例(52.4%),7例痊愈,1例因出血量过多而转行肾脏切除术。结论:手术前的充分准备,提高手术的熟练度,减少手术时间,及时有效的治疗是防治术后大出血的重要保障;对于出现大出血的患者进行及时的介入栓塞止血,可降低肾功能受损的几率。
目的:探究經皮腎鏡碎石術後大齣血的原因及防治措施。方法:2010年1月-2014年9月收治行經皮腎鏡碎石術後大齣血患者21例,分析造成患者齣現術後大齣血的原因,併對原因進行統計學分析,找齣可能引起大齣血髮生率增大的因素,對齣血的預防與控製提供臨床參攷,併對齣血患者進行介入栓塞止血的臨床效果進行分析及討論。結果:21例患者術後齣血量800~2700 mL,平均(1200±680)mL。所有患者齣血後,均先以擴容、輸血、跼部壓迫止血、藥物止血、閉管等保守治療進行止血,齣血情況得到控製10例(47.62%),經緊急介入栓塞治療後止血11例(52.4%),7例痊愈,1例因齣血量過多而轉行腎髒切除術。結論:手術前的充分準備,提高手術的熟練度,減少手術時間,及時有效的治療是防治術後大齣血的重要保障;對于齣現大齣血的患者進行及時的介入栓塞止血,可降低腎功能受損的幾率。
목적:탐구경피신경쇄석술후대출혈적원인급방치조시。방법:2010년1월-2014년9월수치행경피신경쇄석술후대출혈환자21례,분석조성환자출현술후대출혈적원인,병대원인진행통계학분석,조출가능인기대출혈발생솔증대적인소,대출혈적예방여공제제공림상삼고,병대출혈환자진행개입전새지혈적림상효과진행분석급토론。결과:21례환자술후출혈량800~2700 mL,평균(1200±680)mL。소유환자출혈후,균선이확용、수혈、국부압박지혈、약물지혈、폐관등보수치료진행지혈,출혈정황득도공제10례(47.62%),경긴급개입전새치료후지혈11례(52.4%),7례전유,1례인출혈량과다이전행신장절제술。결론:수술전적충분준비,제고수술적숙련도,감소수술시간,급시유효적치료시방치술후대출혈적중요보장;대우출현대출혈적환자진행급시적개입전새지혈,가강저신공능수손적궤솔。
Objective:To discuss the cause and prevention of bleeding after percutaneous nephrolithotomy.Methods:21 patients with percutaneous nephrolithotomy lithotripsy postoperative bleeding were selected from January 2010 to September 2014. Analyzing the cause of hemorrhage patients after operation,and analyzing the clinical data,findding out the factors may cause massive hemorrhage rate increased,and providing clinical reference for the prevention and control of hemorrhage,and interventional embolization hemorrhage clinical results were analyzed and discussed.Results:21 cases of postoperative bleeding 800~2 700 mL,the mean was(1 200 ± 680)mL.All patients bleeding,were the first to expansion,blood transfusion, local hemostasis,drug bleeding,closed tube and other conservative treatment to stop bleeding,bleeding under control 10 cases(47.62%), 11 cases(52.4% )patients after emergency embolization,7 cases were cured,1 case due to excessive bleeding and switch nephrectomy.Conclusion:Sufficient preparation before operation,improving the operation skill,reducing operation time,timely and effective treatment are the important guarantee of prevention and treatment of postoperative hemorrhage;interventional embolization timely for bleeding of patients can reduce the risk of impaired renal function.