经皮肾镜术并发大出血16例报告

１０年中进行４９８例，７２７次经皮肾镜术，发生术中术后大出血１６例，其中部分病例属可以避免的人为因素造成，近年来技术上进行了改进，如采用分期手术，微造瘘技术，用输尿管镜取代肾镜操作可明显降低大出血的发生率。对术后延迟性出血，治疗上使用Ｎｄ：ＹＡＧ激光镜下直视止血是一种十分安全，有效的方法。

Massive renal bleeding following percutaneous nephroscopy

percutaneous nephroscopic manipulation has been carried out during a 10-year's period. Massive renal bleeding during or after the procedure occurred in 16 cases requiring a blood transfusion of 720ml on the average.Among which,43% was due to faulty iatrognic manipulation which could be avoided. With the adoption of two-stage maneuver, mininephrostomy techniques and the use of ureteroscope instead of nephroscope,the danger of massive bleeding could be abated. In case of delayed bleeding following PCNL,transureteroscopic Nd:YAG laser is effective and safe for hemostasis.