Artery Embolization for Severe Hemorrhage after Percutaneous Nephrolithotomy_West China Medical Journal

Authors：

CHEN Yuntao ¹ , LI Li ¹ , WANG Zili ² , YANG Jin. ²

1. Department of Radiology; 2. Department of Urology; Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610081, P. R. China;

Corresponding author：

Keywords：

经皮肾镜取石术; 肾出血; 超选择性肾动脉栓塞

DOI：

10.7507/1002-0179.20130073

Video：

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目的　总结超选择性肾动脉栓塞治疗经皮肾镜取石术后严重出血的临床经验。方法　回顾分析2009年10月－2012年11月行经皮肾镜取石术后发生严重出血的6例（2.74%）患者的临床资料和对其进行超选择性肾动脉栓塞术的血管造影表现和栓塞疗效。结果　患者平均年龄67岁，经皮肾镜取石术后急性出血1例，迟发出血5例，均有体外冲击波碎石史或糖尿病、高血压病史。肾动脉造影显示损伤动脉为肾后下段动脉、肾下段动脉分支，表现为假性动脉瘤5例，动静脉瘘1例。使用弹簧圈或聚乙烯醇颗粒超选择性栓塞，栓塞后出血无一例复发。随访6个月，5例肾功能未见下降，1例受损。结论　经皮肾镜术后严重出血与术中动脉损伤有关，采用超选择性肾动脉栓塞术能够达到迅速止血、尽可能保全患肾功能、有效挽救生命的诊疗效果。

Citation： CHEN Yuntao,LI Li,WANG Zili,YANG Jin.. Artery Embolization for Severe Hemorrhage after Percutaneous Nephrolithotomy. West China Medical Journal, 2013, 28(2): 230-233. doi: 10.7507/1002-0179.20130073 Copy

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5.	何永忠,刘建河, 曾国华, 等.微创经皮肾镜取石术后迟发出血原因及介入治疗[J].中华泌尿外科杂志, 2006, 27(6): 371-373.
6.	Rana AM, Zaidi Z, El-Khalid S. Single-center review of fluoroscopy-guided percutaneous nephrostomy performed by urologic surgeons[J]. J Endourol, 2007, 21 (7): 688-691.
7.	Nambiranjan T, Jeschke S, Albgami N, et al. Role of laparoscopy in management of renal stones: single-center experience and review of literature[J]. J Endourol, 2005, 19(3): 353- 359.
8.	Vassiliu P, Sava J, Toutouzas KG, Velmahos GC. Is contrast as bad as we think? Renal function after angiographic embolization of injured patients[J]. J Am Coll Surg, 2002, 194(2): 142-146.
9.	Phadke RV,Sawlani V, Rastogi H,et al.Latrogenie renal vascular injuries and their radio logieal management[J]. Clin Radiol, 1997, 52(2): 119-123.
10.	Burak T, OktayN, Serkan D, et al. Percutaneous nephrolithotomy: variables that influence hemorrhage[J]. Urology 2007, 69(4): 603-607.

1. 　李逊, 曾国华, 吴开俊, 等.微创经皮肾穿刺取石术治疗上尿路结石[J].临床泌尿外科杂志, 2003, 18(9): 516-518.
2. 　Preminge GM, Assimos DG, Lingeman JE, et al. Chapter 1: AUA guide line on management of staghorn calculi:diagnosis and treatment recommendations[J]. J Urol, 2005, 173(6): 1991-2000.
3. 　袁坚, 吴开俊. 经皮肾镜术并发大出血16例报告[J]. 中华泌尿外科杂志, 1995, 16(9): 530-531.
4. 　Gremmo E, Ballanger P, Dore B, et al. Hemorrhagic complications during percutaneous nephrolithotomy.Retrospective studies of 772 cases[J]. Prog Urol, 1999(3): 460-463.
5. 　何永忠,刘建河, 曾国华, 等.微创经皮肾镜取石术后迟发出血原因及介入治疗[J].中华泌尿外科杂志, 2006, 27(6): 371-373.
6. 　Rana AM, Zaidi Z, El-Khalid S. Single-center review of fluoroscopy-guided percutaneous nephrostomy performed by urologic surgeons[J]. J Endourol, 2007, 21 (7): 688-691.
7. 　Nambiranjan T, Jeschke S, Albgami N, et al. Role of laparoscopy in management of renal stones: single-center experience and review of literature[J]. J Endourol, 2005, 19(3): 353- 359.
8. 　Vassiliu P, Sava J, Toutouzas KG, Velmahos GC. Is contrast as bad as we think? Renal function after angiographic embolization of injured patients[J]. J Am Coll Surg, 2002, 194(2): 142-146.
9. 　Phadke RV,Sawlani V, Rastogi H,et al.Latrogenie renal vascular injuries and their radio logieal management[J]. Clin Radiol, 1997, 52(2): 119-123.
10. 　Burak T, OktayN, Serkan D, et al. Percutaneous nephrolithotomy: variables that influence hemorrhage[J]. Urology 2007, 69(4): 603-607.

West China Medical Journal

Artery Embolization for Severe Hemorrhage after Percutaneous Nephrolithotomy

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