目的：探讨经皮肾镜碎石取石术不同时段出血的原因及护理对策。方法总结分析23例经皮肾镜碎石取石术术中出血、术后迟发性出血、拔肾造痿管时出血及出院后出血的原因及护理方法。结果术中出血6例、术后迟发性出血11例、拔肾造瘘管时出血2例、出院后出血4例，出血量在200~600 ml不等。1例行介入栓塞治疗，5例行经膀胱镜下血块清除术，其余17例行保守治疗，均恢复良好。结论术前做好充分准备，术中操作仔细，掌握操作技巧，可有效减少术中术后出血的发生率；术后密切观察，及时发现，尽早采取有针对性的治疗护理措施，可提高患者的治疗效果。%To explore the causes and nursing countermeasures for different periods hemorrhage of percutane-ous nephrolithotomy. Methods A retrospective analysis for 23 cases of percutaneous nephrolithotomy bleeding, post- operative delayed hemorrhage, pulling nephrostomy tube bleeding and bleeding after discharge was performed to ex-plore the causes and nursing countermeasures. Results Intraoperative bleeding in 6 cases, postoperative delayed hemorrhage in 11 cases, pulling nephrostomy tube hemorrhage in 2 cases and hemorrhage after discharge in 4 cases were found, and the amount of bleeding was in the 200~600 ml range. There was one case given interventional thera-py, 5 cases performed blood clot removal under cystoscopy, and 17 cases treated with conservative therapy. All the cas-es were restored well. Conclusion A sufficient preoperative preparation, careful operating and skilled techniques can effectively reduce intraoperative and postoperative bleeding;and close postoperative observation, timely detection and early treatment can improve clinical efficacy.
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