Analysis of causes and interventional therapy of delayed hemorrhage after PCNL

【摘要】：正Objective To conclude experience in diagnosis and treatment of delayed hemorrhage.Methods During 2006-2010,1036 patients received PCNL in our hospital and delayed hemorrhage occurred in 7 of them; 4 patients with delayed hemorrhage,who received PCNL in other hospitals,were treated by us.11 cases in all: 9 male,2 female;aged 48-75,59.8 in average;6 cases of multiple stones in kidney,3 cases of mold stones,1 case of stones in solitary kidney,1 case of upper ureteral stone.Clinical presentations,causes and interventional therapy of delayed hemorrhage after PCNL are analysed according to these cases.Results After hyperselective renal arteriolar embolizaion and conservative therapy,hematuria disappeared and blood routine、liver function and renal function gradually returned to normal.DSA results:10 cases of false aneurysms,7 of 10 were on lower pole arterial branch,2 cases were on middle pole arterial branch,1 case was on both lower pole arterial branch and middle pole aterial branch;1 case of arteriovenous fistula in lower pole.Concusions False aneurysm and arteriovenous fistula caused by injuries of kidney in PCNL may lead to delayed hemorrhage;hyperselective renal arteriolar embolizaion is an effecive and safe way to cure delayed hemorrhage after PCNL.