超选择性肾动脉栓塞治疗微创经皮肾取石术后严重出血46例报告  

The treatment of severe hemorrhage following MPCNL by super-selective renal arterial embolization

作　　者：吴文起[1] 麦赞林[1] 钟文[1] 陈文忠[1] 曾国华[1] 

机构地区：[1]广州医学院第一附属医院微创外科中心泌尿外科,广东省泌尿外科重点实验室,广州510230

出　　处：《临床泌尿外科杂志》2012年第7期537-539,共3页Journal of Clinical Urology

摘　　要：目的:探讨微创经皮肾镜取石术后严重出血的原因和总结超选择性肾动脉栓塞治疗的经验。方法:对2004年3月～2010年1月微创经皮肾镜取石术后严重出血需行超选择性肾动脉栓塞治疗46例病例进行回顾性分析。结果:46例经肾动脉造影证实22例假性动脉瘤,8例小动脉损伤,8例动静脉瘘,4例假性动脉瘤并动静脉瘘,4例未见动脉病变。46例患者中,36例行一次栓塞术后出血停止,5例行两次栓塞术后出血停止,4例肾动脉造影时未见异常,予灌注止血药物后治愈,1例栓塞术后出血停止但第2天突然死亡。结论:微创经皮肾镜取石术后严重出血主要与手术导致的肾血管损伤有关,超选择性肾动脉栓塞疗效安全确切。Objective：To analyze the reason of severe hemorrhage after MPCNI.,and evaluate the management by Super-selective renal arterial embolization. Method： From March 2004 to January 2010,46 patients with severe hemorrhage after MPCNL requiring the super-selective renal arterial embolization treatment were analyzed retrspectively. Result： Renal arteriography was performed in all 46 patients, 22 false aneurysms,8 little arterial damage, 8 arteriovenous fistulas,4 false aneurysms combined with arteriovenous fistulas were found respectively,and there was not seen any abnormal in 4 patients＇ renal vessel. Among the 46 patients,36 were treated efficiently after the first emholization procedure, however, 5 patients needed second embolization. The positions of bleeding was not seen clearly in 4 patients,but were treated by hemostatic infusion efficiently. 1 patient was dead on the second day after the embolization procedure. Conclusion：The severe hemorrhage after MPCNL is mainly related to the injury of renal vessel during surgery,which can be treated successfully by super-selective renal arterial embolization.

关 键 词：微创经皮肾镜取石术 出血 栓塞 

分 类 号：R454[医药卫生—治疗学]