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目的提高经皮肾镜术后出血处理水平,防止肾脏切除、危及生命等严重后果发生。方法对1 206例经皮肾镜手术并发术后出血的22例患者进行诊治分析,探讨输血指征及介入治疗时机。结果 19例经保守治疗后出血停止,痊愈出院,2例出血剧烈者和1例出血持续16d以上者转上级医院行肾血管栓塞后痊愈。其中输血15例,输血量400~2200 ml。结论经皮肾镜术后出血大部分经内科保守治疗可以治愈,但应积极掌握输血指征,提前输血。对出血剧烈,短时影响生命体征或出血持续16d以上者,尤其基层医院要及时转院行介入治疗。
Objective To improve the level of hemorrhage after percutaneous nephrolithotomy, prevent the excision of the kidneys and endanger the serious consequences of life. Methods Twenty-two patients with postoperative bleeding after percutaneous nephrolithotomy underwent percutaneous nephrolithotomy, and their blood transfusion indexes and the timing of interventional therapy were explored. Results 19 cases of bleeding stopped after conservative treatment, discharged, 2 cases of severe bleeding and 1 case of bleeding continued for more than 16d to the higher hospital after renal vascular embolization recovered. 15 cases of transfusion, blood transfusion 400 ~ 2200 ml. Conclusion Most of the bleeding after percutaneous nephrolithotomy can be cured by conservative medical treatment, but blood transfusion should be actively indications, blood transfusion in advance. Severe bleeding, short-term impact on vital signs or bleeding continued for more than 16d, in particular, the grass-roots hospitals should be timely referral intervention.