选择性肾动脉栓塞在经皮肾镜取石术后迟发性肾出血中的应用  

The application of selective renal arterial embolization in treating delayed renal hemorrhage occurred after percutaneous nephrolithotomy

作　　者：黄源义[1] 周文辉[1] 曹飞[1] 张杏荣[1] 

机构地区：[1]湖北荆州市中心医院介入科,434020

出　　处：《介入放射学杂志》2011年第11期895-897,共3页Journal of Interventional Radiology

摘　　要：目的探讨选择性肾动脉栓塞在经皮肾镜取石(PCNL)术后迟发性肾出血中的应用价值。方法 2010年2月至2011年7月对515例患者行PCNL术,其中25例术后2～7 d发生迟发性肾出血。出血部位右肾16例、左肾9例。对25例患者均行栓塞治疗,栓塞材料采用明胶海绵、聚乙烯醇(PVA)颗粒或弹簧圈。结果造影见出血原因有假性动脉瘤12例,动静脉瘘7例,假性动脉瘤伴动静脉瘘4例,肾下极动脉痉挛1例,1例未见异常。25例均一次栓塞成功,术后随访1～6个月,血尿无复发,无严重并发症发生。结论选择性肾动脉栓塞能有效止血、保存肾功能,对PCNL术后迟发性肾出血的治疗有重要的临床价值。Objective To assess the application value of selective renal arterial embolization in treating delayed renal hemorrhage occurred after percutaneous nephrolithotomy（PCNL）.Methods During the period from Feb.2010 to July 2011,PCNL was carried out in 515 patients.Of the 515 patients,delayed renal hemorrhage occurred in 25 within 2-7 days after PCNL.Selective renal arterial embolization,including 16 right kidneys and 9 left kidneys,was performed by using PVA or Gelfoam particles and/or steel coils as embolic agents.The results were analyzed.Results Successful embolization with single session was achieved in all 25 cases.The lesions included pseudoaneurysms（n = 12）,arteriovenous fistulas（n = 7）,pseudoaneurysms associated with arteriovenous fistulas（n = 4） and renal artery vasospasm at lower pole of the kidney（n = 1）.The remaining one case showed normal findings on DSA.A follow-up lasting for 1-6 months was made.During the follow-up time no recurrence of hematuria was seen and no serious complications occurred.Conclusion Selective renal arterial embolization can promptly stop the renal bleeding and effectively preserve the renal function.Therefore,this technique is of great clinical value in treating delayed renal hemorrhage occurred after PCNL.

关 键 词：肾出血 肾动脉栓塞 血管造影术 经皮肾镜取石 

分 类 号：R692.4[医药卫生—泌尿科学]