Injury to the inferior vena cava and thrombosis caused by percutaneous nephrolithotomy in 2 cases
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摘要: 经皮肾镜取石术(percutaneous nephrolithotripsy，PCNL)术后发现肾造瘘管误入肾静脉并进入下腔静脉是一种罕见并发症，并且在血栓形成后治疗往往困难。回顾性分析我院收治的2例PCNL损伤下腔静脉并血栓形成患者的诊疗过程，得出以下经验体会：PCNL术中切勿盲目过长放置肾造瘘管或采取注水球囊止血；PCNL损伤下腔静脉并血栓形成时，采取早期低分子肝素抗凝，抗凝-影像学监视下分步拔管-抗凝的治疗方案是有效、安全的。Abstract: Inadvertent placement of a nephrostomy tube into the inferior vena cava through the renal vein is a rare complication after percutaneous nephrolithotomy (PCNL), and is often difficult to treat after thrombosis. Through a retrospective analysis of the diagnosis and treatment process of 2 patients with the inferior vena cava injury and thrombosis caused by PCNL, the following experience was obtained: during PCNL, do not blindly place a nephrostomy tube for too long or take a water-injected balloon to stop bleeding; When PCNL injures the inferior vena cava and thrombosis occurs, early use of low-molecular-weight heparin and the therapeutic regimen of anticoagulation-stepwise extubation under imaging surveillance-anticoagulation are effective and safe.
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