Zhou Da-qing, Wang Jian
Department of Urology, Hospital of PLA, Nanning, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2010 Dec;30(12):2768-9.
To investigate the intra- and postoperative hemorrhage of percutaneous nephrolithotomy via the standard nephrostomy tract.
A retrospective analysis was conducted among 1578 patients undergoing percutaneous nephrolithotomy. During the operations, all the nephrostomy tracts were dilated to F24 size after successful puncture. The stones were shattered and removed by EMS lithotrity system.
All the patients showed intra- and postoperative hemorrhage, and in 121 cases, blood transfusion was needed. In 18 patients, the operation had to be terminated for severe hemorrhage. The 8 patients with repeated bleeding were managed and cured by blood transfusion and medication. In another 2 cases, severe hemorrhage was found to result from false aneurysms by renal arteriography and managed by superselective embolization.
Percutaneous nephrolithotomy through standard nephrostomy tract is safe and does not increase the risk of bleeding with careful operation.
探讨经标准肾造瘘通道行经皮肾镜取石术的术中及术后出血情况。
对1578例行经皮肾镜取石术的患者进行回顾性分析。手术过程中，成功穿刺后将所有肾造瘘通道扩张至F24大小。采用EMS碎石系统粉碎并取出结石。
所有患者均出现术中及术后出血，其中121例需要输血。18例患者因严重出血不得不终止手术。8例反复出血患者经输血及药物治疗后得到处理并治愈。另外2例经肾动脉造影发现严重出血是由假性动脉瘤引起，经超选择性栓塞治疗。
经标准肾造瘘通道行经皮肾镜取石术是安全的，操作仔细时不会增加出血风险。
