Analysis And Management Of Frequent Complication In Percutaneous Nephrolithotripsy

Objective To evaluate the occourance of frequent complication in percutaneous nephrolithotripsy(PCNL)and efective management to deal with it.Methods From september2004 to september2008,216 patients with upper urinary calculi underwent PCNL in our hospital,and the clinical data was retrospectively collected,occourance and management to deal with frequent complication were analysed and discussed.Results Among 216 patients with 260 cases of operation,severe complication was found in 7cases(2.7%).There were no severe hemorhage,thoracic and abdominal organ injure in operation;infection(＞38.5℃) after operation was seen in 47 patients(18%), including 4 cases found infectious shock.And 3 patients got well after effective treatment,but the severe multiple organ failure(MOF) came up in the other patient because of the fast progression;7 patients(2.7%) complicated with hemorhage after operation were found.And four of them were cured after occlusion of Renal Pelvis Fistulation Tube or replacement of Foly Catheter,blood transfusion and usage of hemostatics.Because of hemorrhoea the other 3 cases were cured with open operation in the different operating way including nephrectomy,pure renal Hemostasis and renal Hemostasis combined with ultraselective thrombosis of renal artery.Calculus residuing is also a common problem after PCNL,in this group the calculus residuing rate was 28% (60/216) after onestage operation,the rate changed to 7.8%(17/216) after reoperation,so the whole calculus exhausting rate was 92.2%(199/216). Condusions Renal hemorhage in operation,delayed hemorhage and infection after PCNL is the common complication and it needs to take active prevention and cure measure。The mini-invasiveness and repeatablility made PCNL become the first therapeutic tool to cure complex the calculi of upper urinary tract,though the calculus residuing may occur after PCNL.