经皮肾镜取石术后大出血的治疗  

Treatment of kidney hemorrhage after percutaneous nephrolithotomy

作　　者：刘星明[1] 任胜强[1] 徐立奇[1] 邬旭明[1] 蔡雅富[1] 桑乾宏[1] 王强辉[1] 梁宇[1] 

机构地区：[1]解放军第113医院泌尿外科,浙江宁波315040

出　　处：《中国内镜杂志》2010年第9期983-985,共3页China Journal of Endoscopy

摘　　要：目的分析经皮肾镜取石术(PCNL)后大出血的原因及治疗方法。方法对该科接受经皮肾镜取石术后大出血的10例患者资料进行回顾性分析。结果肾旋转不良并肾结石2例,马蹄肾肾结石1例,肾结石并肾积脓2例,孤立肾肾结石2例,肾鹿角形结石、肾铸形结石3例。其中,4例有肾脏开放手术史。10例患者均输血600～1400mL。其中1例开放手术止血,8例在数字减影血管造影(DSA)下高选择性肾动脉栓塞治疗,2～4d尿液转清,1例选择性肾动脉栓塞治疗术后5d再次并发大出血而改开放手术。随访6～12个月,无肾出血复发,肾功能及血压正常,无发生术后肾功能较前损伤加重情况。结论选择性肾动脉栓塞治疗术是治疗经皮肾镜取石术后大出血的首选方法,安全、有效。【Objective】To analyze the causes and the treatment options of kidney hemorrhage after percutaneous nephrolithotomy（PCNL）.【Methods】A restrospective investigation was going on 10 cases suffering from kidney hemorrhage after PCNL from February 2002 to October 2008.【Results】Of all them.Kidney malrotation calculi in 2,1 horseshoe kidney calculi,2 kidney stones with pyonephrosis,2 Solitary kidney calculi and 3 staghorn renal calculi or kevin renal calculi.Among them,4 had kidney operations.All of them had blood transfution from 600 to 1400 mL.One case was cured by operation.8 were cured by highly selective renal artery embolization under digital substraction angiography（DSA）,and urine turned clear from 2 to 4 days postoperatively.After renal artery embolization 5 days,1 had operation because kidney hemorrhage again.All of them were followed from 6 to 12 months,no kidney hemorrhage,normal renal function and blood presser.【Conclusions】Highly selective renal artery embolization is an ideal,safe and effective way to treat kidney hemorrhage.

关 键 词：经皮肾镜取石术 肾出血 数字减影血管造影术 肾动脉栓塞 

分 类 号：R692.4[医药卫生—泌尿科学]