Analysis of factors associated with severe bleeding after percutaneous nephrolithotomy and evaluation of interventional embolization efficacy in male patients
10.3760/cma.j.cn112138-20230618-00317
- VernacularTitle:男性经皮肾镜取石术后严重出血相关因素分析与介入栓塞疗效评价
- Author:
Yongfei GUO
1
;
Tongguo SI
;
Xiujun ZHANG
Author Information
1. 天津市肿瘤医院空港医院微创介入治疗科，天津 300308
- Keywords:
Urinary calculi;
Hemorrhage;
Embolization, therapeutic;
Percutaneous nephrolithotomy
- From:
Chinese Journal of Internal Medicine
2023;62(10):1215-1219
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the factors associated with severe bleeding after percutaneous nephrolithotomy (PCNL) in male patients and evaluate the efficacy of interventional embolization.Methods:A retrospective case series study was conducted at Nankai Hospital of Tianjin, China, from January 2018 to October 2021. The clinical data of 230 male patients with upper urinary tract stones were analyzed. The observation indicators included age, hypertension, diabetes, renal function abnormalities, history of preoperative anticoagulant use, stone size, stone type, number of puncture channels, operation time and degree of hydronephrosis. To describe the clinical characteristics of bleeding after percutaneous nephrolithotomy in men, and analyze the factors associated with severe bleeding after PCNL. Single factor analysis was performed using the Chi-square ( χ2) test, and multivariate analysis was performed using logistic regression analysis. Results:Univariate analysis showed that diabetes mellitus ( χ2=4.90, P=0.027), abnormal renal function ( χ2=18.32, P<0.001), history of preoperative oral anticoagulants ( χ2=5.10, P=0.024), abnormal bleeding and coagulation function ( χ2=8.22, P=0.004) and the number of puncture channels ( χ2=22.08, P<0.001) were the related factors affecting bleeding after PCNL. Multivariate logistic regression analysis showed that diabetes mellitus ( P=0.032), abnormal renal function ( P<0.001), and the number of puncture channels ( P<0.001) were the independent risk factors of bleeding after PCNL. Of the 28 patients with bleeding after PCNL, 25 were treated with interventional embolization, with a technical success rate of 100.0% and a clinical success rate of 89.3%. Conclusions:For patients with renal calculi and comorbid diabetes, renal function abnormalities, and multiple punctures, relevant preventive measures should be actively administered before PCNL to reduce the risk of postoperative bleeding. For patients with severe bleeding of the kidney after PCNL, TAE is a safe and effective minimally invasive treatment method.
