经皮肾镜取石术后肾出血的急诊动脉栓塞治疗  

Emergency embolization therapy for renal hemorrhage after percutaneous nephrolithotomy

作　　者：王磊[1] 徐伟[2] 王宏辉[2] 王法[2] 孟祥兆[3] 

机构地区：[1]哈尔滨医科大学附属第二医院放射科,黑龙江哈尔滨150086 [2]哈尔滨医科大学附属第二医院介入科,黑龙江哈尔滨150086 [3]哈尔滨医科大学附属第二医院检验科,黑龙江哈尔滨150086

出　　处：《实用放射学杂志》2014年第7期1183-1185,共3页Journal of Practical Radiology

摘　　要：目的：探讨经皮肾镜取石术后肾出血患者的急诊动脉造影表现及急诊介入栓塞治疗的疗效。方法21例经皮肾镜取石术后肾出血的患者行急诊动脉造影检查,明确出血部位后,选用明胶海绵条、聚乙烯醇颗粒及弹簧圈栓塞所有出血动脉,并对动脉造影的表现及治疗结果进行回顾性总结评价。结果21例患者动脉造影均可见对比剂外溢,其中4例合并有肾动静脉瘘,3例表现为肾假性动脉瘤破裂。所有患者栓塞后出血均完全停止。术后随诊患者无再次出血及严重并发症出现。结论急诊动脉栓塞治疗经皮肾镜取石术后肾出血是一种安全、有效、微创的方法,合理地选择栓塞剂及全面、彻底地栓塞出血动脉是成功止血的关键。Objective To identify various arteriographic manifestations and the curative effects of emergency embolization of renal hemorrhage after percutaneous nephrolithotomy.Methods Emergency arteriography was performed in 21 patients of renal hemor-rhage after percutaneous nephrolithotomy.Emergency embolotherapy was conducted by using different embolic agents such as gelat-in sponge,polyvinyl alcohol （PVA）particles and coils after bleeding arteries were identified.The arteriographic manifestations and the curative effects of the treatment for renal hemorrhage were retrospectively analyzed.Results Contrast extravasations were con-firmed in 21 patients,among them,4 contrast extravasations with arteriovenous fistulas（AVF）of renal artery;3 pseudoaneurysms of renal artery.The hemorrhage completely stopped after emergent embolotherapy in 21 cases.During follow-up,no rebleedings and severe complications occurred.Conclusion Emergency arterial embolization for renal hemorrhage after percutaneous nephrolithotomy is a safe and effective treatment.The key to successful treatment is to select embolization agent reasonably and embolize the bleeding arteries thoroughly and completely.

关 键 词：经皮肾镜取石术 出血 血管造影 栓塞 

分 类 号：R692[医药卫生—泌尿科学] R814.43[医药卫生—外科学]