超选择性肾动脉栓塞对微创经皮肾镜取石术后肾出血的应用价值(附14例报告)

Application of superselective renal artery embolization in the treatment of hemorrhage after minimally invasive percutaneous nephrolithotomy:a report of 14 cases

目的探讨超选择性肾动脉栓塞在微创经皮肾镜取石术(minimally invasive percutaneous nephrolithotomy,MPCNL)后肾出血的应用价值。方法回顾性分析2003-2009年接受MPCNL治疗839例复杂性上尿路结石患者的临床资料,患者全部采用Seldinger技术穿刺行股动脉插管,进行超选择性肾动脉栓塞治疗。结果术后肾出血经保守治疗无效14例。患者术后1-2d肉眼血尿消失,随访1-24个月无肾出血复发,尿素氮,血肌酐正常。结论超选择性肾动脉栓塞是治疗MPCNL术后并发严重出血的一种安全有效,能较好保护肾脏功能的方法 。

Objective To evaluate the clinical value of superselective renal artery embolization for severe renal hemorrhage after minimally invasive percutaneous nephrolithotomy（MPCNL）. Methods The clinical data of 839 patients with upper urinary tract calculus undergoing MPCNL from 2003 to 2009 were analyzed retrospectively.All patients underwent superselective renal artery embolization with various embolic materials through Seldinger method. Results Of 839 patients,14 developed severe renal hemorrhage after MPCNL.Gross hematuria ceased in all patients in 1-2 d after interventional therapy.No recurrent hemorrhage occurred during 1-24 month follow up.The urea and creatinine in 14 patients were normal. Conclusion Superselective renal artery embolization is an effective and safe way to treat severe renal hemorrhage after MPCNL and protect the renal function.