超选择肾动脉栓塞治疗经皮肾镜取石术后肾动脉出血的疗效

【目的】探讨超选择性肾动脉栓塞治疗经皮肾镜取石术（PCNL）后并发肾动脉出血的临床应用价值。【方法】对38例PCNL后并发肾动脉出血的患者行超选择性肾动脉造影，诊断明确后行栓塞治疗。分析肾动脉造影表现、栓塞疗效及对肾功能的影响等。【结果】肾动脉造影显示34例单纯肾段以下肾小动脉损伤，2例形成动一静脉瘘；2例形成假性动脉瘤。38例患者经超选择插管栓塞后均能有效止血。栓塞范围测定平均为14．64％。所有患者肾功能未受影响，无严重并发症。【结论】超选择性肾动脉造影和栓塞术创伤小，见效快，可明确诊断并有效治疗PCNL术后并发的肾动脉出血，最大限度的保留患者的肾功能。

Superselective Renal Artery Embolization for the Treatment of Renal Artery Hemorrhage Followed by Percutaneous Nephrolithotomy

Objective]To explore the clinical value of superselective renal artery embolization for the treatment of renal artery hemorrhage followed by percutaneous nephrolithotomy（PCNL）. Methods]Totally 38 patients with renal artery hemorrhage followed by PCNL received superselective renoarteriography. Embolization was performed after definite diagnosis. The findings of renoarteriography, the efficacy of embolotherapy and the effect on renal function were analyzed. Results]Renoarteriography showed that 34 patients were simple arteriole damage below kidney segment, 2 patients were arteriovenous fistulas and 2 patients were false aneurysms. Superselective emboli- zation effectively stopped the bleeding of all patients. The mean extent of embolization was 14.64%. Renal func- tion of all patients was not affected. No severe complication occurred. Conclusion]Superselective renoarteriogra- phy and embolization is minimally invasive, and has rapid onset of efficacy, and can confirm the diagnosis and ef fectively treat renal artery hemorrhage followed by PCNL in order to maximatily keep renal function of patients.