白眉蛇毒血凝酶致经皮肾镜碎石取石术后低纤维蛋白原性出血1例报告并文献复习
|
摘要
微创经皮肾镜碎石取石术(MPCNL)是治疗输尿管上段结石及肾结石的常用手术方法。术后出血是最常见、最主要的并发症之一,是由多因素引起的一个并发症。常用保守止血方案为卧床休息、夹闭肾造瘘管、球囊压迫及药物止血等。现报道1例输尿管上段结石伴肾结石患者行MPCNL手术顺利,术后使用白眉蛇毒血凝酶止血治疗,出现低纤维蛋白原血症并引起出血,对该病例进行文献复习,探讨MPCNL术后出血原因、止血方法及白眉蛇毒血凝酶应用注意事项及建议。
Minimally invasive percutaneous nephralithotomy lithotripsy(MPCNL) is a common method for the treatment of upper ureteral calculi and renal calculi. Postoperative bleeding is one of the most common and major complications, it is a complication caused by multiple factors. Commonly used conservative hemostatic schemes are bed rest,closed the renal fistula tube, balloon compression and drug hemostasis. This paper reports a case of a patient with ureteral calculi and renal calculi, who is treating by MPCNL and the operation was smooth. After the operation, Agkistrodon Snake Venom Hemocoagulase was used to treat the patients with hypoproteinemia and hemorrhage, and the patients developed hypofibrinogenemia and bleeding. Literature review was conducted in this case to explore the causes of postoperative hemorrhage after MPCNL, methods of hemostasis, matters needing attention and suggestions for the application of Agkistrodon Snake Venom Hemocoagulase.
Minimally invasive percutaneous nephralithotomy lithotripsy(MPCNL) is a common method for the treatment of upper ureteral calculi and renal calculi. Postoperative bleeding is one of the most common and major complications, it is a complication caused by multiple factors. Commonly used conservative hemostatic schemes are bed rest,closed the renal fistula tube, balloon compression and drug hemostasis. This paper reports a case of a patient with ureteral calculi and renal calculi, who is treating by MPCNL and the operation was smooth. After the operation, Agkistrodon Snake Venom Hemocoagulase was used to treat the patients with hypoproteinemia and hemorrhage, and the patients developed hypofibrinogenemia and bleeding. Literature review was conducted in this case to explore the causes of postoperative hemorrhage after MPCNL, methods of hemostasis, matters needing attention and suggestions for the application of Agkistrodon Snake Venom Hemocoagulase.
引文
[1]袁林,邹小蓉,陈艳梅.注射用白眉蛇毒血凝酶的临床应用调查分析[J].药物流行病学杂志,2015,24(2):122-124.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南[J].2014版.北京:北京人民卫生出版社,2014:139.
[3]Oner S,Okumus MM,Demirbas M,et al.Factors influrncing complicatious of percutaneous nephrolithotomy:a single-crnter study[J].Urol J,2015,12(5):2317-2323.
[4]张智,秦卫军,袁建林,等.经皮肾镜碎石取石术后严重出血相关因素分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(3):194-198.
[5]胡长华,胡晓泉,王磊,等.微创经皮肾取石术的临床疗效和术中及术后出血风险因素分析[J].中华全科医学,2015,13(10):1727-1729.
[6]Karalar M,Tuzel E,Keles L,et al.Effects of parenchymal thickness and stone density values on Percutaneous Nephro lithotomy outcomes[J].Med Sci Monit J,2016,22(14):4363-4368.
[7]黎海新.经皮肾镜取石术后迟发性出血的综合护理[J].中国医药指南,2016,14(2):235-236.
[8]许开良,程帆,饶婷,等.1555例“经肾盏穹隆-盏颈轴线两步穿刺法”建立经皮肾通道碎石取石术出血原因分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(1):3-7.
[9]金有豫.注射用血凝酶及其止血作用机制[J].中国医院用药评价与分析,2012,12(6):488-490.
[10]贾首时,王萌萌.长白山白眉蝮蛇血凝酶的分离纯化研究[J].中国药师,2017,20,(2):212-215.
[11]李广华,卢曼萍,叶联珍,等.低纤维蛋白原血症的临床特点分析[J].血栓与止血学,2015,21(5):215-287.
[12]杨成,占强.白眉蛇毒血凝酶致十二指肠溃疡出血患者低纤维蛋白原血症1例[J].中国中西医结合消化杂志,2016,24(8):642.
[13]张彩霞,刘阳云,刘庚勋,等.鼻内镜术后白眉蛇毒血凝酶致低纤维蛋白原血症1例[J].临床耳鼻喉头颈外科杂志,2016,30(1):70-71.
[14]熊焕腾,程洪波,黄海鹏,等.经尿道前列腺等离子双极电切术后并发原发性纤溶亢进一例报告并文献复习[J].中华泌尿外科杂志,2015,13(6):442-445.
[15]朱国标,肖杰,于丽君,等.继发性凝血功能障碍的输血对策[J].中国输血杂志,2013,26(9):926-927.
[16]潘梦垚,王凯英.蛇毒血凝酶研究进展和在临床应用安全性评价[J].生物技术世界,2012,1(50):4-7.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊断治疗指南[J].2014版.北京:北京人民卫生出版社,2014:139.
[3]Oner S,Okumus MM,Demirbas M,et al.Factors influrncing complicatious of percutaneous nephrolithotomy:a single-crnter study[J].Urol J,2015,12(5):2317-2323.
[4]张智,秦卫军,袁建林,等.经皮肾镜碎石取石术后严重出血相关因素分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(3):194-198.
[5]胡长华,胡晓泉,王磊,等.微创经皮肾取石术的临床疗效和术中及术后出血风险因素分析[J].中华全科医学,2015,13(10):1727-1729.
[6]Karalar M,Tuzel E,Keles L,et al.Effects of parenchymal thickness and stone density values on Percutaneous Nephro lithotomy outcomes[J].Med Sci Monit J,2016,22(14):4363-4368.
[7]黎海新.经皮肾镜取石术后迟发性出血的综合护理[J].中国医药指南,2016,14(2):235-236.
[8]许开良,程帆,饶婷,等.1555例“经肾盏穹隆-盏颈轴线两步穿刺法”建立经皮肾通道碎石取石术出血原因分析[J].中华腔镜泌尿外科杂志(电子版),2018,12(1):3-7.
[9]金有豫.注射用血凝酶及其止血作用机制[J].中国医院用药评价与分析,2012,12(6):488-490.
[10]贾首时,王萌萌.长白山白眉蝮蛇血凝酶的分离纯化研究[J].中国药师,2017,20,(2):212-215.
[11]李广华,卢曼萍,叶联珍,等.低纤维蛋白原血症的临床特点分析[J].血栓与止血学,2015,21(5):215-287.
[12]杨成,占强.白眉蛇毒血凝酶致十二指肠溃疡出血患者低纤维蛋白原血症1例[J].中国中西医结合消化杂志,2016,24(8):642.
[13]张彩霞,刘阳云,刘庚勋,等.鼻内镜术后白眉蛇毒血凝酶致低纤维蛋白原血症1例[J].临床耳鼻喉头颈外科杂志,2016,30(1):70-71.
[14]熊焕腾,程洪波,黄海鹏,等.经尿道前列腺等离子双极电切术后并发原发性纤溶亢进一例报告并文献复习[J].中华泌尿外科杂志,2015,13(6):442-445.
[15]朱国标,肖杰,于丽君,等.继发性凝血功能障碍的输血对策[J].中国输血杂志,2013,26(9):926-927.
[16]潘梦垚,王凯英.蛇毒血凝酶研究进展和在临床应用安全性评价[J].生物技术世界,2012,1(50):4-7.