泌尿系CT血管造影结合DSA在经皮肾镜碎石取石术后肾出血介入栓塞中的临床应用  

Clinical Application of CT Angiography of Urinary System for Interventional Embolization of Renal Hemorrhage after Percutaneous Nephrolithotomy

作　　者：谭少庆 柳健 谢安明 魏文峰 查婧 范华刚 黎蕾 TAN Shaoqing;LIU Jian;XIE Anming;WEI Wenfeng;ZHA Jing;FAN Huagang;LI Lei(Interventional Therapy Room,Diagnostic Radiology Department,the 908th Hospital of Joint Support Force,Nanchang 330002,Jiangxi,P.R.China)

机构地区：[1]联勤保障部队第908医院放射诊断科介入治疗室,江西南昌330002

出　　处：《影像科学与光化学》2024年第6期630-637,共8页Imaging Science and Photochemistry

基　　金：江西省卫生健康委科技计划项目(202211354)。

摘　　要：目的:探究CT血管造影(CTA)结合数字减影血管造影(DSA)在经皮肾镜碎石取石术(PCNL)后肾出血患者介入栓塞治疗中的应用效果。方法:选取2018年6月至2023年6月期间接受PCNL治疗后肾出血的60例患者,分别行DSA和CTA结合DSA检查,明确出血类型和位置后,实施介入栓塞治疗,并评估治疗效果。结果:DSA检查显示假性动脉瘤11例,动静脉瘘型6例,其他类型43例;CTA结合DSA检查则显示假性动脉瘤23例,动静脉瘘型10例,其他类型27例。介入栓塞治疗中,26例使用金属弹簧圈,13例使用吸收性明胶海绵颗粒,16例结合使用两者,5例采用聚乙烯醇(PVA)栓塞。治疗后,57例患者出血症状得到有效控制,3例经二次栓塞后控制出血,10例患者术后存在腰部不适,8例出现发烧症状,26位患者感到恶心和呕吐,但是在相应治疗后这些症状均消失。结论:CTA结合DSA在PCNL术后肾出血介入栓塞治疗中具有精准定位作用,并能准确评估治疗效果。Objective:To explore the application effect of computed tomography angiography(CTA)combined with digital subtraction angiography(DSA)during interventional embolization for patients with renal hemorrhage after percutaneous nephrolithotomy(PCNL).Methods:60 patients with renal hemorrhage after PCNL treatment were selected from June 2018 to June 2023.DSA,CTA combined with DSA were performed respectively.After the hemorrhage type and location were clarified,interventional embolization was carried out and the therapeutic effect was evaluated.Results:DSA examination showed 11 cases of pseudoaneurysm,6 cases of arteriovenous fistula type and 43 cases of other types,and CTA combined with DSA examination showed 23 cases,10 cases and 27 cases respectively.During interventional embolization,metal spring coil was used in 26 cases,absorbable gelatin sponge granule was used in 13 cases, a combination of both in 16 cases and polyvinyl alcohol (PVA) particle embolization in 5 cases. After treatment, the hemorrhage symptoms of 57 patients were effectively controlled, 3 patients were controlled after secondary embolization, 10 patients had postoperative lumbar discomfort, 8 patients had fever, and 26 patients felt nausea and vomiting, but these symptoms disappeared after corresponding treatment. Conclusion: CTA combined with DSA has a precise positioning effect during interventional embolization for renal hemorrhage after PCNL and can accurately evaluate the therapeutic effect.

关 键 词：泌尿系统 CT血管造影 数字减影血管造影 经皮肾镜碎石取石术 肾出血 介入栓塞 

分 类 号：R619[医药卫生—外科学]