Objective To explore the risk factors for postoperative bleeding in kidney stones patients with percutaneous nephrolithotomy (PCNL),and provide a reference for clinical treatment.Methods Retrospective review was conducted to get clinical data of 50 cases of kidney stones patients with PCNL in our hospital from January 2010 to December 2012,and analyzed the factors that may affect bleeding (gender,liver function insufficiency,diabetes,high blood pressure,blood creatinine,stones shape,degree of hydronephrosis,urinary tract infections,surgical time,renal insufficiency,puncture path).Logistic regression analysis was used to analyze a variety of factors and the relationship between blood transfusion,so as to identify the major risk factors affecting bleeding.Results 95.57％ of the patients with the PCNL postoperative disposable completely stone,no obvious postoperative adverse reactions found,and efficacy in patients had good prognosis.Logistic regression analysis found that the major risk factors leading to the PCNL postoperative bleeding were stones shape,surgery,diabetes and renal insufficiency (P =0.000,0.041,0.006,0.004).Conclusion Patients with kidney stones need to be controlled with blood sugar levels before surgery,recovery of renal function and reduce the operation time,thus reducing the risk of postoperative bleeding.%目的 探讨肾结石患者PCNL术后出血的危险因素,为临床治疗提供参考.方法 对2010年1月至2012年12月我院行PCNL术治疗肾结石的145例患者进行资料回顾,分析可能影响出血的因素(性别、肝功能不全、糖尿病、高血压、血肌酸酐、结石形状、肾积水程度、尿路感染、手术时间、肾功能不全、穿刺路径),采用Logistic多因素回归分析各种因素与是否输血之间的关系,从而找出影响出血的主要危险因素.结果 95.57％的患者PCNL术后一次性完全取石,术后未发现明显不良反应,患者疗效与预后效果良好.Logistic多因素回归分析发现,PCNL术后出血的主要危险因素有结石形状、手术时间、糖尿病和肾功能不全(P=0.000,0.041,0.006,0.004).结论 肾结石患者术前需要控制血糖水平、恢复肾功能、减少手术时间,从而降低术后出血风险.
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