经皮肾镜术后肾包膜下巨大血肿的治疗

发表时间：2014-07-08 浏览次数：1232次

引用：

何文强，尹继云，孟晓等.经皮肾镜术后肾包膜下巨大血肿的治疗[J].临床泌尿外科杂志.2013,28(4):285- 286

关键词：

经皮肾镜；肾包膜下血肿；引流；尿激酶；

作者：

何文强，尹继云，孟晓，张文涛，曲宪东，李南南

作者单位：

武警河南总队医院泌尿外科

出版年份：

2013

期刊页数：

285- 286

收录者：

知网

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2～3d,通过引流管分别向血肿内注射3万U的尿激酶并保留24h,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 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: Percutane- ous 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 1一19 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 he- matoma are potentially method to treat subcapsular renal hematoma resulted from percutaneous nephrolithotomy.

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