经皮肾镜取石术后难治性肾脏出血的肾动脉造影表现及选择性肾动脉栓塞的应用

Performance of Renal Arteriography and Application of Selective Renal Artery Embolism of Re- fractory Renal Hemorrhage after Percutaneous Nephrolithotomy

【目的】探讨经皮肾镜碎石术（percutaneous nephrolithotomy，PCNL）术后难治性肾脏出血的肾动脉造影表现及行选择性肾动脉栓塞的应用价值。【方法】对2005年1月至2010年12月13例行肾动脉造影和选择性肾动脉栓塞的PCNL术后难治性肾脏出血患者的肾动脉造影表现和选择性栓塞治疗进行回顾性分析。【结果】1例出院转入的血性休克患者因休克难以纠正发生弥漫性血管内凝血（DIC），于术后当天死亡，其余12例患者均栓塞成功，效果满意，未出现明显栓塞术后并发症。【结论】假性动脉瘤和动静脉瘘是PCNI。术后难治性肾脏出血肾动脉造影的典型表现，选择性肾动脉栓塞治疗是一种安全、有效的治疗方法。

[Objective] To explore the performance of renal arteriography and application value of selective renal artery embolism of refractory renal hemorrhage after percutaneous nephrolithotomy（PCNL）. [Methods] The performance of renal arteriography and application value of selective renal artery embolism of refractory renal hemorrhage after PCNL between Jan. 2005 and Dec. 2010 were analyzed retrospectively. [Results] One patient with hemorrhage shock died of shock failed to the treatment. Other 12 patients achieved satisfactory ef ficacy after embolism. No obvious postoperative complication caused by embolization was observed. [Conclusion] Pseudoaneurysm and arteriovenous fistula are typical manifestations of renal arteriography of re- fractory renal hemorrhage after PCNL. Selective renal artery embolism is a safe and effective method.