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目的观察经肾造瘘管持续缓慢静脉滴注血凝酶预防肾镜碎石取石术(PCNL)后出血的可行性及安全性。方法选取医院收治的186例择期行PCNL的患者,将其分为血凝酶组(63例)、生理盐水组(61例)和对照组(62例)。对比3组患者术后72 h内出血量及并发症发生率。结果血凝酶组、生理盐水组、对照组术后72 h出血量分别为(32.43±7.23)ml、(54.11±8.37)ml、(58.30±8.11)ml,血凝酶组术后72 h出血量显著低于其余2组,差异均有统计学意义(P<0.05)。血凝酶组、生理盐水组、对照组并发症发生率分别为17.5%(11/63)、16.4%(10/61)、17.7%(11/62),3组术后并发症发生率比较差异无统计学意义(P>0.05)。各种并发症中最常见的为伤口漏尿。结论经肾造瘘管持续缓慢静脉滴注血凝酶预防泌尿外科术后出血的疗效显著,且并未增加发生并发症的危险性。
Objective To observe the feasibility and safety of continuous slow intravenous infusion of hemagglutinin to prevent hemorrhage after renal nephrostomy (PCNL) by renal fistula. Methods A total of 186 patients with PCNL undergoing elective surgery were enrolled in the study. They were divided into six groups: 63 patients in the coagulation enzyme group, 61 in the saline group and 62 in the control group. The bleeding volume and complication rate in the three groups were compared within 72 hours after operation. Results The hemorrhage volume at 72 h after operation in hemagglutinin group, saline group and control group was (32.43 ± 7.23) ml, (54.11 ± 8.37) ml and (58.30 ± 8.11) ml, respectively. Hemorrhagic The difference was statistically significant (P <0.05). The incidences of complications in the hemagglutinin group, saline group and control group were 17.5% (11/63), 16.4% (10/61), and 17.7% (11/62), respectively The difference was not statistically significant (P> 0.05). The most common complication of wound leakage urine. Conclusion The sustained and slow intravenous infusion of hemagglutinin by renal fistula to prevent bleeding after urological surgery has a significant effect, and did not increase the risk of complications.