经皮肾镜取石术后大出血的超选择性栓塞治疗  

Superselective embolization in the treatment of severe hemorrhage after percutaneous nephrolithotomy

作　　者：李定明[1] 沈朋飞[1] 王佳[1] 

机构地区：[1]四川大学华西医院泌尿外科,四川成都610041

出　　处：《四川医学》2013年第7期918-919,共2页Sichuan Medical Journal

摘　　要：目的探讨经皮肾镜取石术后大出血的原因,总结超选择性肾动脉栓塞治疗的经验。方法回顾四川大学华西医院2007年11月～2012年11月所有行经皮肾镜取石术的1963例患者中,9例术后大出血患者保守治疗无效后行肾动脉数字减影动脉造影检查,均行超选择性肾动脉栓塞治疗。结果造影发现肾动脉假性动脉瘤8例,动静脉瘘1例,均一次性栓塞成功,平均随访6个月,无新发出血,患者肾功能良好,无严重并发症发生。结论超选择性肾动脉栓塞止血可作为经皮肾镜取石术后大出血治疗安全可靠的首选方法,能有效保护肾功。Objective To analyze the causes of severe hemorrhage after percutaneous nephrolithotomy（PCNL）,and to summarize the experiences of superselective renal arterial embolization.Methods During the period from November 2007 to November 2012 in West China Hospital of Sichuan University,PCNL was carried out in 1963 patients,digital subtractionarteriography was performed in 9 cases of severe hemorrhage after PCNL who failed to respond to conservative managements,superselective renal arterial embolization was performed in all of them.Results Arteriography showed 8 cases of renal arterial false aneurysm and 1 cases of arteriovenous fistula.All cases received interventional embolization with successful results.Follow-up 6 months on the average found no rehaemorrhagia,no renal disfunction and severe complications occurred.Conclusion Superselective renal arterial embolization could be the preferred method in the treatment of severe hemorrhage after PCNL which is safe and reliable,and effectively preserve the renal function.

关 键 词：经皮肾镜取石术 出血 动脉造影 超选择性栓塞 

分 类 号：R692.4[医药卫生—泌尿科学]