经皮肾镜取石碎石术术后大出血的介入治疗

Interventional treatment of severe hemorrhage after percutaneous nephrolithotomy

目的评价超选择性肾动脉栓塞术治疗经皮肾镜取石碎石术(PCNL)术后大出血经保守治疗无效的患者的价值。方法 2589例患者接受PCNL,46例术后出现明显出血,对其中37例保守治疗无效者行超选择性肾动脉栓塞术。结果超选择性肾动脉栓塞术术后,37例出血均得到有效控制,随访期间无再次血尿及其他严重并发症。结论超选择性肾动脉栓塞术是治疗PCNL术后大出血安全、有效的手段,可作为保守治疗无效患者的首选治疗方法。

Objective To observe the therapeutic effect of superselective renal artery embolization for severe hemorrhage after percutaneous nephrolithotomy（PCNL）with no-effect on conservative treatment.Methods Clinical data of 2589 patients underwent PCNL were reviewed.Forty-six patients developed severe hemorrhage after PCNL,among them 37 were treated with super selective renal artery embolization while other therapies showed no effect.Results The bleeding of all the 37 patients ceased immediately after embolization.No serious complications and hematuria occurred during the following-up period（2 months—5 years）.Conclusions Superselective renal artery embolization is a safe and effective method in the treatment of severe hemorrhage after PCNL.It is the best way while other therapies show no effect.