长期留置输尿管支架后出现输尿管动脉瘘二例报告  

Two cases report of uretero-arterial fistula with long term indwelling of ureteral stent

作　　者：陆超[1] 花豹 顾欣[1] 宋尚卿 茅原申[1] 李文峰[1] 杨广林[2] 徐斌[1] 刘玉衫 蔡志康[1] 王忠[1] Lu Chao;Hua Bao;Gu Xin;Song Shangqing;Mao Yuanshen;Li Wenfeng;Yang Guanglin;Xu Bin;Liu Yushan;Cai Zhikang;Wang Zhong(Department of Urology,Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China;Department of Vascular Surgery,Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 201999,China)

机构地区：[1]上海交通大学医学院附属第九人民医院泌尿外科,201999 [2]上海交通大学医学院附属第九人民医院血管外科,201999

出　　处：《中华泌尿外科杂志》2021年第10期786-787,共2页Chinese Journal of Urology

摘　　要：输尿管动脉瘘(UAF)是长期留置输尿管支架后出现的罕见并发症。本文报道2例,均有盆腔肿瘤手术、放疗史,均有输尿管皮肤造口及长期留置输尿管支架史。例1,女,52岁,2020年4月2日因输尿管皮肤造口内间歇出血1周入院。CT检查见左侧上尿路积血。行左肾切除术后左输尿管仍有出血,改开放手术见左输尿管盆腔段粘连明显、游离困难,遂切除输尿管远端,保留粘连段输尿管,两端结扎,术后诊断UAF,随访8个月未再出血。例2,男,82岁,2020年6月15日因输尿管皮肤造口出血1 h入院,增强CT检查发现左输尿管与髂总动脉交叉,考虑UAF,行介入手术,术中行左侧髂内动脉栓塞及髂总动脉、髂外动脉覆膜支架置入。术后即刻出血停止,随访6个月未再出血。Ureteral artery fistula(UAF)is a rare complication after long-term indwelling of ureteral stent.In this study,two cases were presented.Both of them underwent pelvic tumor surgery and radiotherapy,and had a history of cutaneous terminal ureterostomy and long-term indwelling of ureteral stents.The first case,a 52-year-old female,was admitted to hospital because of intermittent bleeding from ureteral dermostomy for 1 week on April 2,2020.CT examination revealed hematocele in the left upper urinary tract,and left nephrectomy was performed.However,bleeding still presented and the distal ureteral resection was performed at the same time,and partial ureteral was ligated.Postoperative diagnostic was ureteral artery fistula.After 8 months of follow-up,no recurrent bleeding presented.Another case,a 82-year-old male,was admitted to hospital because of bleeding at the ureteral dermostomy for an hour on June 15,2020.Contrast enhanced CT examination revealed intersecting of the left ureter and common iliac artery,and interventional surgery was performed,by which UAF was diagnosed.Embolization of left internal iliac artery and stent implantation of common iliac artery and external iliac artery were performed intraoperatively.The bleeding stopped immediately after the operation,and there was no further bleeding during follow-up of 6 months.

关 键 词：输尿管疾病 瘘 支架 并发症 血管腔内技术 

分 类 号：R699.4[医药卫生—泌尿科学]