论文部分内容阅读
目的探讨医源性血尿的动脉造影诊断及其血管内介入治疗的价值。资料与方法 24例医源性血尿患者,依据其临床治疗经过,采用Seldering技术行一侧股动脉穿刺插管,选择性行患侧肾动脉或双侧髂内动脉造影,以微导管行超选择性造影,明确出血原因、具体部位,以明胶海绵碎屑或/并微弹簧圈栓塞。最后行栓塞后造影,观察栓塞情况。结果 24例动脉造影均获得明确诊断,其中经皮肾盂穿刺造瘘术后局部肾动脉小分支损伤、局部假性动脉瘤形成、全血尿8例,经皮肾穿刺取石术后肾动脉小分支损伤全血尿6例,超声碎石术后肾实质损伤全血尿2例,前列腺癌、前列腺增生症摘除术后手术区渗血、全血尿7例,男性尿道医源性损伤出血1例。所有病例栓塞治疗后止血效果明显,无并发症发生。结论对于医源性全血尿患者,依据其临床治疗经过,行患侧肾动脉或双侧髂内动脉造影具有定性定位诊断价值,经微导管对所涉动脉分支超选择性栓塞能成功控制出血。
Objective To investigate the value of arterial angiography in diagnosis of iatrogenic hematuria and its interventional therapy in endovascular treatment. Materials and Methods According to the clinical treatment, 24 cases of iatrogenic hematuria were treated with Seldering technique. One side femoral artery puncture cannula was used to select the ipsilateral renal artery or bilateral internal iliac artery. Sexual imaging, a clear cause of bleeding, specific parts, with gelatin sponge debris or / and coil coil embolization. After the final embolization angiography, embolism observed. Results All the 24 cases of arterial angiography were diagnosed well. Among them, the local renal artery branches were injured after percutaneous nephroureterectomy, local pseudoaneurysm formation, 8 cases of hematuria, small renal artery lesion after percutaneous nephrolithotomy 6 cases of hematuria, 2 cases of renal parenchymal injury after ultrasonic lithotripsy, 2 cases of prostatic cancer and benign prostatic hyperplasia, 7 cases of hematuria, 1 case of iatrogenic urethral hemorrhage. All cases of embolization hemostatic effect is obvious, no complications. Conclusion For patients with iatrogenic hematuria, according to their clinical treatment, the ipsilateral renal artery or bilateral iliac artery angiography has the value of qualitative localization diagnosis. The transcatheter arterial branch superselective embolization via micro-catheter can successfully control the bleeding.