输尿管镜气压弹道碎石术并发肾包膜下血肿1例诊治体会

Subcapsular renal hematoma after ureteroscopy: case report

目的分析输尿管镜气压弹道碎石术后并发肾包膜下血肿的原因及诊治体会。方法女性输尿管下段结石患者1例入院后接受输尿管镜气压弹道碎石术,术中患者诉患侧腰腹部剧烈疼痛,术后第2天出现头晕、贫血貌、血色素进行性下降,经妇科会诊排除妇科情况,急诊复查腹部CT提示:左肾包膜下血肿,予绝对卧床休息、输血、抗生素预防感染等保守治疗。结果患者病情逐渐康复,出院后门诊多次复查,血肿趋于缩小,最终康复。结论输尿管镜碎石术后并发肾包膜下血肿是少见的并发症,需严格按照肾外伤保守治疗方案进行治疗,必要时采用血管介入或外科手术干预。

Objective To analyze the cause of subcapsular renal hematoma induced by ureteroscopic pneumatic lithotripsy for treating ureteral calculi. Methods The patient who suffered from lower ureteric calculi was treated with six times of extracorporeal shock wave lithotripsy in other hospital, while the treatment was failed. After the patient was admitted to our hospital, she received ureteroscopic pneumatic lithotripsy, and the patient complained of abdominal pain during the operation, then the patient developed into severe anemia on the second day postoperatively, then emergent abdominal and pelvic CT scan were performed, and the result was subcapsular renal hematoma. A conservative treatment was given, including absolute bed rest, analgetic use, and antibiotic therapy and so on. Result After conservative treatment, the patient condition stabilized, and she received regular outpatient follow - up, eventually, the patient completely recovered. Conclusion Subcapsular renal hematoma is a rare complication after ureteroscopy, and the conservative treatment is the main therapeutic method, if necessary, endovascular or surgical intervention should be adopted.