摘要
目的:探讨介入栓塞治疗经皮肾镜取石术( PCNL)后顽固性血尿的临床疗效。方法回顾性分析我院2014年2月至2016年3月行PCNL后出现顽固性血尿36例患者的临床资料。所有患者均经过保守治疗无效,于我院行肾动脉造影明确病变,行Embosphere微球或聚乙烯醇颗粒联合弹簧圈介入栓塞治疗。术后观察尿色变化情况、术后并发症及随访观察有无再次出血。结果(1)成功率:36例患者均一次成功栓塞成功,术后1~3 d血尿症状逐渐消失,止血有效率达到100%。(2)并发症:术后10例患者出现不同程度的栓塞后综合征,给予止痛、止吐等治疗后症状逐渐缓解。1例患者术后出现一过性肌酐升高,经对症治疗7 d后肾功能恢复正常。(3)随访:术后随访3~6月均无再次出血。结论经导管介入栓塞治疗顽固性血尿,疗效确切,创伤小,安全性高,并发症少,术后恢复快。
Objective To investigate the clinical effect of interventional embolization in the treatment of intractable hematuria after percutaneous nephrolithotripsy. Methods A retrospective analysis of the First Affili-ated Hospital of Kunming Medical University from February 2014 to March 2016 after percutaneous nephrolithot-omy appears intractable hematuria patients in 36 cases was conducted. All patients were treated with conservative treatment but invalid,then lesion was confirmed by renal artery angiography,after that,line embosphere micro-spheres or polyvinyl alcohol particles combined with spring ring interventional the treatment was conduc-ted. Postoperative urine color changes, postoperative complications and follow-up were observed whether have bleeding again. Results ( 1) The success rate:36 cases patients all with successful embolization,the symptoms of hematuria in 1-3 days gradually disappeared,and the effective rate was 100%. ( 2) Complications:the compli-cations after operation in 10 patients appeared different degree of embolism syndrome,given analgesic and antie-metic,the symptoms gradually ease after treatment. One case patient with a transient increase of creatinine after operation,renal function returned to normal 7 days after the treatment. ( 3) Follow up:there was no recurrence of hemorrhage after 3-6 months of follow-up. Conclusion Transcatheter embolization in the treatment of intracta-ble hematuria has definite curative effect,less trauma,high safety,less complications and faster postoperative re-covery.
出处
《中国综合临床》
2016年第10期928-931,共4页
Clinical Medicine of China
关键词
顽固性血尿
超选择性肾动脉栓塞
Intractable hematuria
Super selective renal artery embolization