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作 者:梁卓寅[1] 曾国华[1] 吴文起[1] 陈秀萌[2] 叶向东[1] 陈嘉华[1]
机构地区:[1]广州医学院附属第一医院微创外科中心泌尿外科,广州510230 [2]广州医学院附属第一医院泌尿内科,广州510230
出 处:《中华腔镜泌尿外科杂志(电子版)》2007年第2期81-83,共3页Chinese Journal of Endourology(Electronic Edition)
摘 要:目的探讨经皮肾穿刺取石术后出血的原因和介入栓塞治疗的经验。方法对2006年6月至2007年6月经皮肾穿刺取石术后并发大出血行超选择性肾动脉栓塞治疗8例进行回顾性分析。结果 8例患者7例一次性治愈,1例肾动脉造影时不见造影剂外溢或驻留,5 d后在大出血时再次行肾动脉造影发现造影剂外溢,行栓塞治疗后治愈。8例经肾动脉造影证实:2例假性动脉瘤,5例动静脉瘘,1例假性动脉瘤合并动静脉瘘。8例患者的肾功能在栓塞治疗前后没有变化。结论经皮肾穿刺取石术后出血的原因与手术导致肾血管损伤有关,超选择性肾动脉栓塞治疗疗效确切。Objective To analyse the hemorrhage of PCNL, to evaluate the management by Super-selective renal arterial embolization. Methods From June 2006 to June 2007, 8 patients with severe haemorrhage after PCNL requiring a Super-selective renal arterial embolization procedure were analyzed retrospectively. Results Renal arteriography was performed in all 8 patients, 2 false aneurysms, 5 arteriovenous fistulas, 1 false aneurysms combined with arteriovenous fistulas. Out of 8 patients, 7 were therapied efficiently after the first embolization procedure. One patient, however, the position of haemorrhage was not clear, after 5 days the second embolization was performed effectively. Conclusions Superselective renal arterial embolization is a safe and effective method for the treatment of the severe haemorrhage after PCNL, which is related to the injury of renal vessel.
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