微创医学

目的评价生物蛋白胶(BFG)在微创经皮肾镜碎石术(MPCNL)后迟发性出血中的应用价值。方法本组2例病例,1例为MPCNL术后第7天拔肾造瘘管时出血,另1例MPCNL术后第5天下床活动后出血,均经其它保守治疗无效后,向肾盂内注入BFG(例1经输尿管导管,例2经肾造瘘管腔)。结果例1于灌注BFG15min后输尿管导管引流液开始变淡,6h后彻底变清;膀胱内尿液于12h后变清。例2于灌注BFG30min后尿色逐渐变淡,10h后尿液变清。两例均于术后1个月取出双J管,复查经静脉尿管造影(IVU)和Scr正常。结论BFG在肾内局部应用对MPCNL术迟发性出血具有止血作用,但仍需进一步探讨其有效性和安全性。

Objective To assess the value of biomedical fibrin glue(BFG) on the treatment of hemorrhage after minimally invasive percutaneous nephrolithotripsy (MPCNL).Methods Of the two cases in this group,the first had hemorrhage when nephric fistula was extracted 7 days after MPCNL,and the second had hemorrhage when the patient moved 5 days after MPCN.While the two cases of hemorrhage were of no effect by conservative treatment,biomedical fibrin glue was infused into renal pelvic through ureter catheter ( in the first case) or nephric fistula (in the second case).Results For the first case,the color of urine effused from ureter catheter attenuated 15 min after BFG infusion,turned clear 6h after,and so did the urine in bladder 12h after.As for the second case,the color of urine in bladder revealed weak 30min after BFG infusion,and clear 10h after.When two patients’ double J catheter were drawn out 1 month after operation,reexamination of IVU and Scr returned normal.Conclusion BFG has the effect of hemostasis in treatment of hemorrhage after MPCNL,but its efficacy and safety need further research.

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