微导管联合微钢圈栓塞治疗经皮肾镜取石术后难止性肾出血

目的:探讨经微导管置放微钢圈栓塞治疗经皮肾镜取石术(PCNL)后难止性肾出血的方法和效果。方法:回顾性分析2006～2011年接受PCNL治疗后难止性肾出血13例,采用股动脉插管,行肾动脉造影明确出血动脉后,以微导管行超选择性出血动脉内释放微钢圈栓塞治疗。结果:13例患者栓塞后48 h内肉眼血尿消失,所有病例随访6～12个月肾出血无复发,尿素氮、血肌酐正常,无治疗并发症。结论:肾动脉造影和经微导管超选择性出血动脉内释放微钢圈栓塞治疗PCNL术后难止性出血,创伤小、见效快,可最大限度保护肾功能,应作为首选治疗方法。

Superselective renal artery embolization with microcoils in the treatment of severe hemorrhage after percutaneous nephrolithotomy

Objective:To evaluate the effect and techniques of superselective renal artery embolization with microcoils in the treatment of severe renal hemorrhage after percutaneous nephrolithotomy(PCNL).Methods: Thirteen patients with severe renal hemorrhage after percutaneus nephrolithotomy from 2006 to 2011 were analyzed retrospectively.Superselective angiography and renal artery embolization with microcoils were performed in all patients.Results:Gross hematuria ceased in all patients in 48 hours after interventional embolic therapy.No recurrent hemorrhage occurred during 1-12 months follow-up.The serum urea and creatinine levels were normal in 13 patients.Conclusion:Superselective renal artery emblization with microcoils is reliable and effective in the treatment of severe hemorrhage followed by PCNL and for the protection of the function of kidney.