超选择性肾动脉分支栓塞术治疗经皮肾镜取石术术后肾出血

Superselective renal artery branch embolization for renal hemorrhage after percutaneous nephrolithotomy

目的评价超选择性肾动脉分支栓塞术治疗经皮肾镜取石术(PCNL)术后肾出血的临床价值。方法对PCNL术后并发肾出血的35例患者行超选择性肾动脉分支栓塞术,栓塞材料为0.018in微弹簧圈,部分病例加用少量明胶海绵颗粒。术后随访3～24个月。结果术中造影发现24例单纯肾段以下小动脉损伤,6例合并假性动脉瘤,5例合并动静脉瘘。全部35例患者均成功栓塞肾动脉出血分支,术后1～4天血尿症状消失,术中及术后无严重并发症发生。结论超选择性肾动脉分支栓塞术治疗PCNL术后肾出血安全、快速、有效,可成为其首选治疗方法。

Objective To observe the clinical value of superselective renal artery branch embolization in patients with re- nal hemorrhage after percutaneous nephrolithotomy （PCNL）. Methods Superselective renal artery branch embolization was performed in 35 patients with renal hemorrhage caused by PCNL using 0. 018 in microcoils and gelatin sponge particles in some patients. Follow-up ranged from 3 to 24 months. Results Simple segmental artery injury was detected in 24 pa- tients, while concurrent pseudoaneurysm and arteriovenous fistula was found in 6 and 5 cases, respectively. All bleeding renal artery branches of 35 patients were embolized successfully. And the symptoms of hematuria disappeared 1-4 days af- ter operation without serious perioperative and postoperative complications. Conclusion Superselective renal artery branch embolization is a safe, fast and effective method, which can be used as a preferred method in the treatment of renal hemor- rhage after PCNL.