输尿管镜钬激光碎石术继发肾脏出血原因分析

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。

Causes Analysis of Renal Hemorrhage Due to Holmium Laser Ureterolithotripsy

Objective：To discuss the causes of renal hemorrhage due to holmium laser ureterolithotripsy. Methods：Retrospective analysis of. clinical data of 9 cases of renal hemorrhage complication in holmium laser ureterolithotripsy from February 2007 to May 2010. Results：There were intraoperative hemorrhage in 4 cases, postoperative hemorrhage in 5 cases. All 9 cases were cured and discharged home. Among them, five cases achieved hemostasis after conservative treatment, two cases were controlled bleeding by selective renal artery embolization, and one by inject thrombin into the kidney pelvis, one by open operation. Conclusions： The measures of perfect preoperative preparation, skillful surgical technique, intraoperative intermittent and low-pressure infusion of fluid are the key points to reduce the incidence of renal hemorrhage.