摘要
目的总结微创经皮肾镜取石术并发严重出血的诊治体会。方法回顾性分析1995年1月-2004年2月收治的3857例微创经皮肾镜取石术的患者资料。14例并发严重出血（0.4％），男11例，女3例；年龄20—68岁，平均45岁。结果早期3例为止血行患肾切除术。11例行肾动脉造影术，其中肾动静脉瘘5例，假性动脉瘤4例，肾动静脉瘘合并假性动脉瘤1例，肾血管损伤1例。11例均经超选择性肾动脉栓塞术治愈。结论微创经皮肾镜取石术并发严重出血是一种少见且难以预测的并发症，选择性肾动脉造影＋栓塞术是诊断和治疗微创经皮肾镜取石术并发严重出血安全、有效的方法。
Objective To investigate the management of severe haemorrhage following minimally invasive percutaneous nephrolithotomy. Methods A retrospective study was accomplished on 3857 patients of minimally invasive percutaneous nephrolithotomy from Jan 1995 to Feb 2004. Fourteen patients, 11 males and 3 females with a mean age of 45 years, developed severe haemorrhage requiring a haemostasis procedure （0. 4% ）. Results Three cases of nephrectomies for haemostasis were performed at the beginning of our experience. Renal arteriography was performed in 11 patients, and the results showed that 5 patients were suffered with arteriovenous fistulas, 4 cases with false aneurysms, 1 case with arteriovenous fistulas and false aneurysms, and 1 case with arteriolar injury. All the patients with vascular abnormalities were successfully treated by highly selective embolization. Conclusion The severe haemorrhage following minimally invasive percutaneous nephrolithotomy is a rare complication, but impossible to be predicted. Renal arteriography and selective embolization is a safe and effective procedure for the management of severe haemorrage following minimally invasive percutaneous nephrolithotomy.
出处
《中国医师杂志》
CAS
2006年第4期479-481,共3页
Journal of Chinese Physician
