超选择性肾动脉栓塞治疗经皮肾镜取石术后严重出血  

Clinical value of selective renal arterial emobilization for treatment of sever hemorrh-age following percutaneous nephroli thotomy

作　　者：苗颖[1] 布桂林[1] 

机构地区：[1]广西壮族自治区南溪山医院放射科,广西桂林541002

出　　处：《影像研究与医学应用》2017年第1期19-21,共3页Journal of Imaging Research and Medical Applications

摘　　要：目的:探讨超选择性肾动脉栓塞治疗经皮肾镜取石术(MPCNL)术后严重出血的临床价值。方法:回顾性分析23例肾结石MPCNL术后严重出血患者的肾动脉造影表现、栓塞治疗效果及并发症。结果:肾动脉造影结果显示MPCNL后出血的表现:单纯假性动脉瘤10例(43.4%)、假性动脉瘤伴对比剂外渗3例(13.1%)、假性动脉瘤伴动-静脉瘘1例(4.3%),动-静脉瘘3例(13.1%)、对比剂外渗4例(17.4%),未发现异常2例(8.7%)。23例接受了栓塞治疗,21例一次栓塞成功,成功率为91.3%(21/23),2例二次栓塞成功,无严重并发症,术后1月~1年随访,无再发出血。结论:超选择性肾动脉栓塞止血效果好,对肾脏功能影响小,是MPCNL术后严重出血的首选治疗方法。Objective： To assess the clinical value of selective renal anerial emboliz-arion for treatment of severe hemorrage following percutaneous nephrolithoromy. Methods： 23 cases of the image manifestartion of renal arteriography, the effects and complications a-fter embolotherapy were retrospectively reviewed. Results： The shows of bleeding after M-PCNL included simple pseudoaneurysms （10/23,43.4%）,pseudoaneurysms accampanied with contrast agent extravasation（3/23, 13.1% ）,pseudoaneurysms accampanied with arterial venous fistula（1/23,4.3%）,arterial venous fistula（3/23,13.1%）,contrast agent extravasation（4/23,17.4%）,No obvious cause was found in 2 casesC2/23,8.7%）.21 cases were treated by selective ren- al arterial embolization successfully at the first time. two patient recovered after the secon-d treatment.No hemorrhage recurrence appeared during the one month to I year follow upperi0d.Condusion： Selective renal arterial embalization is effective in the diagnosis and treatment and keep main function of the kidney,It is the first choice in the treatment of the patients who suffered severe hemorrhage caused by MPCNL.

关 键 词：出血 血管造影术 动脉栓塞 经皮肾镜取石 

分 类 号：R699[医药卫生—泌尿科学]