经皮肾镜术后肾包膜下巨大血肿的治疗(附16例报告)

何文强; 尹继云; 孟晓; 张文涛; 曲宪东; 李南南

经皮肾镜术后肾包膜下巨大血肿的治疗(附16例报告)

- 武警河南总队医院泌尿外科(郑州, 4500520)

详细信息

通讯作者: 何文强,E-mail:qiangwen0519@163.com

中图分类号: R699

收稿日期: 2012-12-06

Minimal invasive treatment of subcapsular renal hematoma resulted from percutaneous nephrolithotomy (Report of 16 cases)

- Department of Urology, Henan Provincal Corps Hospital of Chinese People's Armed Police Force, Zhengzhou, 450052, China

More Information

Corresponding author: HE Wenqiang, E-mail: qiangwen0519@163.com

Received Date: 06 December 2012

摘要

摘要: 目的：探讨经皮穿刺置管引流和尿激酶局部注射治疗经皮肾镜术后肾包膜下巨大血肿的价值。方法：经皮肾镜术后形成肾包膜下巨大血肿16例，出血停止1~3周后，在B超定位下行经皮血肿穿刺置管引流术，引流出陈旧性积血后，每间隔2~3 d，通过引流管分别向血肿内注射3万U的尿激酶并保留24 h，然后充分引流。结果：经皮穿刺置管引流陈旧性积血后，间断注射尿激酶溶解血块，30~35天后复查CT显示血肿明显减小，仅为治疗前的1/19~1/56。16例患者经1~2年随访，无继发性出血、感染、高血压等并发症。结论：对经皮肾镜术后肾包膜下巨大血肿患者行经皮血肿穿刺置管引流，同时应用尿激酶局部注射溶解血凝块，可有效溶解引流肾包膜陈旧性出血和血凝块，具有推广价值。
- 经皮肾镜 /
- 肾包膜下血肿 /
- 引流 /
- 尿激酶
Abstract: Objective: To investigate the value of percutaneous drainage of the hematoma and local application of urokinase to treat subcapsular renal hematoma resulted from percutaneous nephrolithotomy.Method: Percutaneous drainage of the hematoma was undertaken to treat 16 patients with subcapsular renal hematoma, then 30,000 U urokinase was injected into subcapsular renal hematoma and reserved 24 hours every other 2 or 3 days.Result: The ratio of the residual hematomo volume comparing to that of pre-therapy was from 1/19 to 1/56 in 30-35 days CT scan through the treatment of percutaneous drainage of the hematoma and local application of urokinase. In 16 patients, followed up for 12 years the complications of active bleeding, infection and hypertension were not found.Conclusion: Percutaneous drainage of the hematoma and local application of urokinase to treat subcapsular renal hematoma are potentially method to treat subcapsular renal hematoma resulted from percutaneous nephrolithotomy.
- percutaneous nephrolithotomy /
- subcapsular renal hematoma /
- drainage /
- urokinase

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