CAJ | 학술논문

目的：探讨经皮肾镜取石术后肾出血患者的急诊动脉造影表现及急诊介入栓塞治疗的疗效。方法21例经皮肾镜取石术后肾出血的患者行急诊动脉造影检查,明确出血部位后,选用明胶海绵条、聚乙烯醇颗粒及弹簧圈栓塞所有出血动脉,并对动脉造影的表现及治疗结果进行回顾性总结评价。结果21例患者动脉造影均可见对比剂外溢,其中4例合并有肾动静脉瘘,3例表现为肾假性动脉瘤破裂。所有患者栓塞后出血均完全停止。术后随诊患者无再次出血及严重并发症出现。结论急诊动脉栓塞治疗经皮肾镜取石术后肾出血是一种安全、有效、微创的方法,合理地选择栓塞剂及全面、彻底地栓塞出血动脉是成功止血的关键。
목적：탐토경피신경취석술후신출혈환자적급진동맥조영표현급급진개입전새치료적료효。방법21례경피신경취석술후신출혈적환자행급진동맥조영검사,명학출혈부위후,선용명효해면조、취을희순과립급탄황권전새소유출혈동맥,병대동맥조영적표현급치료결과진행회고성총결평개。결과21례환자동맥조영균가견대비제외일,기중4례합병유신동정맥루,3례표현위신가성동맥류파렬。소유환자전새후출혈균완전정지。술후수진환자무재차출혈급엄중병발증출현。결론급진동맥전새치료경피신경취석술후신출혈시일충안전、유효、미창적방법,합리지선택전새제급전면、철저지전새출혈동맥시성공지혈적관건。
Objective To identify various arteriographic manifestations and the curative effects of emergency embolization of renal hemorrhage after percutaneous nephrolithotomy.Methods Emergency arteriography was performed in 21 patients of renal hemor-rhage after percutaneous nephrolithotomy.Emergency embolotherapy was conducted by using different embolic agents such as gelat-in sponge,polyvinyl alcohol (PVA)particles and coils after bleeding arteries were identified.The arteriographic manifestations and the curative effects of the treatment for renal hemorrhage were retrospectively analyzed.Results Contrast extravasations were con-firmed in 21 patients,among them,4 contrast extravasations with arteriovenous fistulas(AVF)of renal artery;3 pseudoaneurysms of renal artery.The hemorrhage completely stopped after emergent embolotherapy in 21 cases.During follow-up,no rebleedings and severe complications occurred.Conclusion Emergency arterial embolization for renal hemorrhage after percutaneous nephrolithotomy is a safe and effective treatment.The key to successful treatment is to select embolization agent reasonably and embolize the bleeding arteries thoroughly and completely.