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目的:探讨输尿管镜钬激光碎石术继发肾脏出血的原因和防治策略。方法:回顾性分析2007年2月～2010年5月9例输尿管镜钬激光碎石术继发肾脏出血患者的临床资料。结果:术中出血4例,术后出血5例。9例中5例采取保守治疗,2例行超选择性肾动脉栓塞术,1例行肾盂内凝血酶注入,1例改开放手术。9例均治愈出院。结论:作好充分的术前准备,提高手术技巧,术中灌注液低压并间断冲洗是防止肾盂内高压致肾脏出血的关键。
Objective: To investigate the causes and control strategies of ureteroscopic holmium laser lithotripsy secondary to renal hemorrhage. Methods: The clinical data of 9 patients with ureteroscopic holmium laser lithotripsy secondary to renal hemorrhage from February 2007 to May 2010 were retrospectively analyzed. Results: 4 cases of intraoperative bleeding, postoperative bleeding in 5 cases. Of the 9 patients, 5 received conservative treatment, 2 received super-selective renal artery embolization, and 1 received renal pelvis thrombin infusion. One patient underwent open surgery. All 9 cases were cured. Conclusion: To make adequate preoperative preparation, improve surgical skills, intraoperative perfusion fluid low pressure and intermittent irrigation is to prevent renal pyelonephritis caused by the key to bleeding.