摘要
目的评价超选择性肾动脉栓塞治疗PCNL后严重出血的效果及其对肾功能的影响。方法2008年5月至2010年2月，7例MPCNL术后严重出血患者，男5例，女2例。年龄28—68岁，中位年龄55岁。结石单发2例，多发5例，其中铸型结石2例。结石位于下组肾盏4例，中组肾盏1例，上组肾盏2例，肾盂和输尿管上段4例。患者术后平均10．7d出血，出血持续1—14d，总出血量600～1800ml。实验室检查：SCr77—186μmol／L，平均94μmol／L；BUN2．58—8．03mmol／L，平均4．85mmol／L。行超选择性肾动脉造影和弹簧钢圈栓塞治疗。结果肾动脉造影示假性动脉瘤6例，其中合并动静脉瘘1例；未显示出血灶1例。6例均成功地进行了肾动脉弹簧钢圈栓塞治疗，术后3～7d出血停止。术后2周复查SCr为59～98μmol／L，平均78．3μmol／L，BUN为1．86～6．92mmol／L，平均4．80mmol／L。结论超选择性肾动脉栓塞治疗PCNL术后严重出血效果显著，肾功能受损轻，是临床首选的治疗手段。
Objective To evaluate the outcome of super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy （PCNL） and its effect on renal function. Methods From May 2008 to Feb 2010, severe bleeding occurred in 7 patients after PCNL in our hospital. （5 males and 2 females, average age of 54.9 years）. All cases were treated with superelective renal angiography and 6 cases underwent microcoil embolization. Results Renal angiography showed pseudoaneurysm in 5 cases, pseudoaneurysm with arteriovenous fistula in 1 case and no severe bleeding in 1 case. Successful coil embolization was confirmed in 6 cases by angiography, and bleeding stopped within 3 -7 days after embolization. Serum creatinine and blood urea nitrogen were 59 -98 μmol/L（ mean, 78.3 μmol/L） and 1.86 - 6.92 mmol/L（mean, 4.8 mmol/L） 2 weeks after embolization, respectively. Conclusions Super-selective embolization of renal artery for severe hemorrhage after percutaneous nephrolithotomy has the advantages of remarkable hemostatic effects and mild impaired renal function, which is of the first choice.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第1期41-43,共3页
Chinese Journal of Urology
关键词
经皮肾镜取石术
出血
栓塞
介入放射学
Percutaneous nephrolithotomy
Hemorrhage
Embolization
Interventional radiol- ogy
