超选择性肾动脉栓塞治疗微创经皮肾镜取石术后出血(附5例报告)

目的 探讨超选择性肾动脉栓塞治疗微创经皮肾镜取石术后继发出血的临床价值.方法 回顾和分析我院2003年2月～2007年5月应用微创经皮肾镜取石术(MPCNL)治疗上尿路结石1311例术后并发出血行超选择性肾动脉栓塞治疗5例的资料.结果 5例中4例一次性治愈,1例3d后再次行栓塞治疗后治愈.5例患者栓塞后出血立即得到控制.出血原因:1例肾动脉损伤,3例假性动脉瘤,1例动静脉瘘.术后无一例发生栓塞后综合症、异位栓塞现象及其他介入治疗并发症.5例术后1个月复查肾图、IVU和B超声,患肾功能均有不同程度改善,术后无明显肾功能损害.结论 超选择性肾动脉栓塞是MPCNL术后出血治疗的首选方法,安全性高,疗效好.

Super-selective renal arterial embolization in treatment of hemorrhage after mini-percutaneous nephrolithotomy (Reports of 5 cases)

Objective To investigate the experience in treatment of hemorrhage after mini-percutaneous nephrolithotomy with super-selective renal arterial embolization(SRAE).Methods From Feb 2003 to May 2007, 1311 cases of mini-percutaneous nephrolithotomy, 5 cases of massive bleeding were treated with super-selective renal arterial embolization( SRAE).Results In 5 cases,4 cases were successfully with first treated of SRAE, 1 healed after second time.Bleeding was controlled thoroughly.1 case was injury of renal artery,3 cases were arterial pseudoaneurysm and 1 case was arteriovenous fistula.No embolization syndromes,ectopic embolism and other interventional complications happened. The renogram,intravenous urogram and B-ultrasound were rechecked followed-up one month and renal function was ameliorated respectively.Conclusion Surper-selective renal arterial embolization is the right method in treatment of hemorrhage after p ercutaneous nephrolithotomy.