Ketsuwan Chinnakhet, Pimpanit Narutsama, Phengsalae Yada, Leenanupunth Charoen, Kongchareonsombat Wisoot, Sangkum Premsant
Division of Urology, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Res Rep Urol. 2020 Jul 22;12:279-285. doi: 10.2147/RRU.S261888. eCollection 2020.
Percutaneous nephrolithotomy (PCNL) is accepted as the gold standard of care for the treatment of large renal calculi. Kidney hemorrhage, which requires blood transfusion, is one of the most common complications after percutaneous kidney stone surgery.
To evaluate perioperative factors associated with transfusion requirements during PCNL.
A total of 226 patients with kidney calculi undergoing PCNL between January 2011 and December 2019 were reviewed retrospectively. We analyzed the impact of perioperative clinical factors on the necessity of blood transfusion during PCNL.
The overall blood transfusion rate was 9.29%. Multiple perioperative determinants were significantly correlated with the application of packed red blood cells (PRCs), including larger stone size (p = 0.006), multiple tract punctures (p = 0.029), presence of staghorn calculi (p = 0.026), and long operative time (OT; p = 0.017). Multivariate analysis demonstrated that only multiple tract punctures independently affected blood transfusion requirements during PCNL (p = 0.038).
In accordance with the present study, only the multiple tract punctures were associated with blood transfusion requirements in PCNL.
经皮肾镜取石术（PCNL）被公认为治疗大型肾结石的金标准治疗方法。需要输血的肾出血是经皮肾结石手术后最常见的并发症之一。
评估经皮肾镜取石术（PCNL）期间与输血需求相关的围手术期因素。
回顾性分析2011年1月至2019年12月期间共226例行PCNL的肾结石患者。我们分析了围手术期临床因素对PCNL期间输血必要性的影响。
总体输血率为9.29%。多个围手术期决定因素与浓缩红细胞（PRC）的应用显著相关，包括结石尺寸较大（p = 0.006）、多通道穿刺（p = 0.029）、鹿角形结石的存在（p = 0.026）和手术时间长（OT；p = 0.017）。多变量分析表明，只有多通道穿刺独立影响PCNL期间的输血需求（p = 0.038）。
根据本研究，在经皮肾镜取石术中，只有多通道穿刺与输血需求相关。
