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：

經皮腎鏡取石術; 腎出血; 超選擇性腎動脈栓塞

DOI：

10.7507/1002-0179.20130073

Video：

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目的　總結超選擇性腎動脈栓塞治療經皮腎鏡取石術后嚴重出血的臨床經驗。方法　回顧分析2009年10月－2012年11月行經皮腎鏡取石術后發生嚴重出血的6例（2.74%）患者的臨床資料和對其進行超選擇性腎動脈栓塞術的血管造影表現和栓塞療效。結果　患者平均年齡67歲，經皮腎鏡取石術后急性出血1例，遲發出血5例，均有體外沖擊波碎石史或糖尿病、高血壓病史。腎動脈造影顯示損傷動脈為腎后下段動脈、腎下段動脈分支，表現為假性動脈瘤5例，動靜脈瘺1例。使用彈簧圈或聚乙烯醇顆粒超選擇性栓塞，栓塞后出血無一例復發。隨訪6個月，5例腎功能未見下降，1例受損。結論　經皮腎鏡術后嚴重出血與術中動脈損傷有關，采用超選擇性腎動脈栓塞術能夠達到迅速止血、盡可能保全患腎功能、有效挽救生命的診療效果。

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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3.	袁堅, 吳開俊. 經皮腎鏡術并發大出血16例報告[J]. 中華泌尿外科雜志, 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,劉建河, 曾國華, 等.微創經皮腎鏡取石術后遲發出血原因及介入治療[J].中華泌尿外科雜志, 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. 　李遜, 曾國華, 吳開俊, 等.微創經皮腎穿刺取石術治療上尿路結石[J].臨床泌尿外科雜志, 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. 　袁堅, 吳開俊. 經皮腎鏡術并發大出血16例報告[J]. 中華泌尿外科雜志, 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,劉建河, 曾國華, 等.微創經皮腎鏡取石術后遲發出血原因及介入治療[J].中華泌尿外科雜志, 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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