血管栓塞术治疗泌尿系出血的价值

Clinical value of the vascular embolization for the urinary tract hemorrhage

目的探讨血管栓塞术在泌尿系出血中的作用和价值。方法对29例泌尿系大出血,包括17例患者行血管栓塞术治疗,总结血管栓塞术的疗效和操作中的注意点。结果所有病例栓塞后6-48小时内出血逐渐停止,随访期1-24月,无复发出血病例;29例中1例肾癌出血院外两次栓塞后复发,经碘化油、无水乙醇及钢圈栓塞后未出血;1例微创经皮肾镜取石后肾血管损伤出血行明胶海绵栓塞术中出血加重,经钢圈栓塞后未出血;1例尿道球海绵体出血明胶海绵栓塞后未出血,阴茎勃起功能无明显减退。结论血管栓塞治疗泌尿系出血的创伤小,疗效显著,是一种安全有效的止血方法。

Objective To explore the clinical value of the vascular embolization for the urinary tract hemorrhage. Methods Vascular interventional embolization treatment was performed in 29 cases with urinary tract hemorrhage, including 17 cases of renal carcinoma, 2 cases of renal angiomyolipomas, 2 cases of advanced bladder tumor, 2 cases of severe hemorrhage after minimally invasive percutaneous neophrolithotomy（MPCNL） and 2 cases of hemorrhage of bulbocavernosus body. The curative effect of vascular embolization treatment and the attention points in operation were evaluated. Results Hemorrhage was stopped after 6-48 hours, and no recurrence was observed during the follow up of 1 months to 2 years. 1 case of renal carcinoma with hemorrhage relapse after twice interventional embolization treatment in other hospitals was treated successfully by the embolization materials of lipiodol, absolute alcohol and steel coils. 1 case of severe hemorrhage after MPCNL developed hemorrhage in operation, and was treated successfully by the embolization materials of steel coils. 1 case of hemorrhage of hulbocavernosus body was treated successfully by the embolization materials of gelfoam particles or strips, and penis erection function was not decrease. Conclusion It is suggested that vascular embolization treatment is a safe and efficient method with minimally invasive for treatment urinary tract hemorrhage.