经皮肾镜取石术后出血行超选择性肾动脉栓塞时机探讨(1)
[摘要] 目的 探讨经皮肾镜取石术后出血行超选择性肾动脉栓塞的合理时机。方法 方便选取该院2014年月1月—2018年12月期间上尿路结石患者1 298例(共1 192个肾脏)接受经皮肾镜取石术治疗，手术治疗后20例患者由于严重出血而接受超选择性肾动脉栓塞治疗。该次研究就回顾性分析20例患者的出血特点和接受超选择性肾动脉栓塞治疗时机。结果 全部患者中接受1次超选择性肾动脉栓塞治疗后止血成功的患者共19例，其中1例患者在超选择性肾动脉栓塞治疗前接受单纯性肾动脉造影;接受2次超选择性肾动脉栓塞治疗后止血成功的患者共1例。全部患者接受初次单纯性肾动脉造影或超选择性肾动脉栓塞时血色素平均降低(33.0±2.2)g/L，输血量(247.6±16.8)mL;再次接受单纯性肾动脉造影或超选择性肾动脉栓塞时血色素平均降低(3.15±0.51)g/L，未进行输血;20例患者均康复出院。结论 经皮肾镜取石术后严重出血患者需尽早开展超选择性肾动脉栓塞，初次单纯性肾动脉造影阴性或超选择性肾动脉栓塞后再出血患者需酌情开展超选择性肾动脉栓塞。
[关键词] 经皮肾镜取石术;肾结石;选择性肾动脉栓塞
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)06(b)-0095-03
[Abstract] Objective To investigate the rational timing of superselective renal artery embolization after percutaneous nephrolithotomy. Methods Convenient select a total of 1 298 patients (1 192 kidneys) who underwent upper urinary calculi during the period from January 2014 to December 2018 in our hospital were treated with percutaneous nephrolithotomy. 20 patients underwent surgery for severe bleeding selective renal artery embolization. This study retrospectively analyzed the bleeding characteristics of 20 patients and the timing of treatment with superselective renal artery embolization. Results A total of 19 patients with successful hemostasis after one-time superselective renal artery embolization were treated in all patients. 1 patient underwent simple renal angiography before superselective renal artery embolization; A total of 1 patients with successful hemostasis after renal artery embolization. All patients underwent primary simple renal angiography or superselective renal artery embolization with a decrease in hemoglobin (33.0±2.2) g/L， blood transfusion (247.6±16.8) mL; re-acceptable simple renal angiography or superselective kidney mean hemoglobin was decreased (3.15±0.51) g/L during arterial embolization， and no transfusion was performed; 20 patients were discharged from hospital. Conclusion Patients with severe hemorrhage after percutaneous nephrolithotomy should undergo superselective renal artery embolization as soon as possible. Patients with primary simple renal angiography or re-selective renal artery embolization should be treated with superselective renal artery embolization as appropriate.
[Key words] Percutaneous nephrolithotomy; Kidney stones; Selective renal artery embolization
經皮肾镜取石术后最容易出现的并发症之一为肾脏出血，不但会使患者的疾病治疗花费提高，甚至可对患者的生命构成威胁[1-2]。随着临床研究的不断深入，超选择性肾动脉栓塞成为对经皮肾镜取石术后肾脏出血进行治疗的主要方法，其疗效确切，可使正常肾组织的功能得到最大程度的保留，但对于其应用时机并无过多报道[3]。该次研究方便选取2014年月1月—2018年12月该院泌尿外科收治的上尿路结石患者1 298例，探讨经皮肾镜取石术后出血行超选择性肾动脉栓塞的合理时机。报道如下。, 百拇医药(简国登)
[关键词] 经皮肾镜取石术;肾结石;选择性肾动脉栓塞
[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742(2019)06(b)-0095-03
[Abstract] Objective To investigate the rational timing of superselective renal artery embolization after percutaneous nephrolithotomy. Methods Convenient select a total of 1 298 patients (1 192 kidneys) who underwent upper urinary calculi during the period from January 2014 to December 2018 in our hospital were treated with percutaneous nephrolithotomy. 20 patients underwent surgery for severe bleeding selective renal artery embolization. This study retrospectively analyzed the bleeding characteristics of 20 patients and the timing of treatment with superselective renal artery embolization. Results A total of 19 patients with successful hemostasis after one-time superselective renal artery embolization were treated in all patients. 1 patient underwent simple renal angiography before superselective renal artery embolization; A total of 1 patients with successful hemostasis after renal artery embolization. All patients underwent primary simple renal angiography or superselective renal artery embolization with a decrease in hemoglobin (33.0±2.2) g/L， blood transfusion (247.6±16.8) mL; re-acceptable simple renal angiography or superselective kidney mean hemoglobin was decreased (3.15±0.51) g/L during arterial embolization， and no transfusion was performed; 20 patients were discharged from hospital. Conclusion Patients with severe hemorrhage after percutaneous nephrolithotomy should undergo superselective renal artery embolization as soon as possible. Patients with primary simple renal angiography or re-selective renal artery embolization should be treated with superselective renal artery embolization as appropriate.
[Key words] Percutaneous nephrolithotomy; Kidney stones; Selective renal artery embolization
經皮肾镜取石术后最容易出现的并发症之一为肾脏出血，不但会使患者的疾病治疗花费提高，甚至可对患者的生命构成威胁[1-2]。随着临床研究的不断深入，超选择性肾动脉栓塞成为对经皮肾镜取石术后肾脏出血进行治疗的主要方法，其疗效确切，可使正常肾组织的功能得到最大程度的保留，但对于其应用时机并无过多报道[3]。该次研究方便选取2014年月1月—2018年12月该院泌尿外科收治的上尿路结石患者1 298例，探讨经皮肾镜取石术后出血行超选择性肾动脉栓塞的合理时机。报道如下。, 百拇医药(简国登)