Objective To investigate the cause of severe bleeding caused by percutaneous nephroscopy pneumatic and ultrasound lithotripsy misoperation, and to sum up preventive measures. Methods Retrospective analysis of the clinical data of 17 cases of complex renal calculi treated by percutaneous nephrolithotomy pneumatic ballistic ultrasonic lithotripsy and had severe bleeding in our hospital during March 2012 and February 2014 were made. Results In the 17 cases, bleeding a-mount was over 300 ml. Bleeding was effectively controlled in 12 cases by channel compression hemostasis, fistula traction and hemostasis medicine conservative treatment. 5 cases of postoperative bleeding, 2 cases of conservative treatment were effec-tive, and 3 cases were controlled after renal artery embolization. After a follow up for 2-5 months, the normal renal function was recovered in all the patients and no bleeding occurred again. Conclusion Improper selection of puncture position, re-peated renal biopsy gravel and improper extubation operation are the main causes of kidney stones in patients with percutaneous nephroscopic and ultrasonic lithoclast and ultrasound and severe bleeding in operation, and postoperative bleeding. Conserva-tive treatment and renal artery embolization can control severe hemorrhage, and reduce the damage to the kidneys.%目的：探讨经皮肾镜气压弹道超声碎石术误操作致严重出血的原因,总结防治措施。方法回顾性分析我院2012年3月—2014年2月行经皮肾镜气压弹道超声碎石术发生严重出血的复杂肾结石17例的临床资料。结果17例出血量均>300 ml；术中出血的12例经通道压迫止血、造瘘管牵引以及予止血药等保守治疗有效控制出血；5例术后出血,其中 2例保守治疗有效,3例行肾动脉栓塞治疗后出血控制。随访2~5个月,所有患者肾功能均正常,且均未发生再出血。结论穿刺位置选择不当、反复肾穿刺、碎石及拔管操作不当是导致肾结石患者经皮肾镜气压弹道超声碎石术中、术后严重出血的主要原因。保守及肾动脉栓塞治疗可确切控制出血,降低对肾脏的损害。
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