经皮肾镜取石术后出血的介入治疗的经验和技巧  

Experience and skills of super-selective renal artery embolization in treating post-percutaneous nephrolithotomy hemorrhage

作　　者：甘澍[1] 王树声[1] 陈志强[1] 白遵光[1] 黄钦展[1] 周建甫[1] 孟凡喆[2] 杨志刚[2] 向松涛[1] 

机构地区：[1]广东省中医院泌尿外科,广州510120 [2]广东省中医院介入科

出　　处：《临床泌尿外科杂志》2015年第7期594-596,共3页Journal of Clinical Urology

基　　金：广东省科技计划项目(编号2011B061300077)

摘　　要：目的：探讨经皮肾镜取石术（PCNL）后出血的超选择性肾动脉栓塞治疗（SRAE）的临床经验和技巧。方法：我院2007年1月～2014年9月期间施行PCNL手术者2306例，其中术后发生出血保守治疗失败后行SRAE治疗者10例，结果：10例患者中，肾动脉假性动脉瘤5例，肾动静脉瘘4例，阳性率90％，均栓塞后成功。1例患者两次肾动脉造影均未见明显出血部位，拔除肾引流管后保守治疗成功。结论：SRAE治疗PCNL术后假性动脉瘤或动静脉瘘出血者疗效显著，符合指征者宜早治疗；充分掌握SRAE的技巧有利于提高阳性率和成功率。Objective： To explore clinical experience and skills in treating post-percutaneous nephrolithotomy （PCNL） hemorrhage with super-selective renal artery embolization （SRAE）. Method： The clinical data of ten post- operative hemorrhage patients treated with SRAE after PCNL of 2 306 cases from January 2007 to September 2014 were collected. Clinical characteristics of ten patients were retrospectively analyzed. Result：Five of them were diag- nosed as renal artery pseudoaneurysm, and four of them were diagnosed as renal arteriovenous fistula. The posi- tive rate was 90~. Only one case has not be seen obvious bleeding after two times of renal arteriography, and the clinical result was excellent after pulling out the drainage tube and conservative treatment. Conclusion：SRAE has obvious therapeutic effect in treating hemorrhage after PCNL, so diagnosed patients should be treated as early as possible. The perfect SRAE skills can improve the positive rate and the success rate of SRAE.

关 键 词：经皮肾镜取石术 出血 超选择性肾动脉栓塞治疗 

分 类 号：R699.2[医药卫生—泌尿科学]