超选择性肾动脉栓塞治疗MPCNL术后肾出血

The Treatment of Selective Renal Arterial Embolization for Kidney Hemorrhage After Mini-invasive Percutaneous Nephrolithotomy(MPCNL)

目的研究MPCNL术后肾出血的介入止血方法和效果。方法 2008年4月至2009年10月间经MPCNL治疗上尿路结石后肾出血患者15例,行超选择性肾动脉栓塞治疗术,回顾性分析其临床资料。结果本组患者治疗后效果满意,一次栓塞成功14例(93.3%),1例栓塞后另一血管分支再出血,经第二次栓塞血止。结论介入方法治疗MPCNL术后肾出血具有安全、有效、创伤小、预后好、恢复快等优点,是MPCNL术后肾出血的首选手术方法之一。

Objective Kidney hemorrhage after mini-invasive percutaneous nephrolithotomy（MPCNL）,however,including renal artery branch injuries,often require surgical intervention and result in partial or total nephrectomy.Nonoperative management of kidney hemorrhage after MPCNL following complete radiographic assessment has become an accepted if not preferred therapeutic option.In this article,we will study the methods and treatment effects of selective renal arterial embolization on kidney hemorrhage after MPCNL.Methods From April 2008 to October 2009,15 cases with nephrorrhagia after MPCNL underwent interventional therapy of selective renal arterial embolization.Results Overall,14 of 15 patients had prompt hemostasis documented either on the post-embolization angiogram or by clinical assessment.In 1 patient,bleeding was recurred and another transcatheter embolization was required.The technical successful rate with single session was 93.3%（14/15）.There was no complication occurred after the selective renal arterial embolization.Conclusion The angiography with transcatheter embolization techniques provides a safe and effective means of managing renal artery branch injuries secondary to MPCNL.