目的：探讨超选择性肾动脉栓塞(superselective renal artery embolization，SRAE)治疗肾出血的临床疗效。方法：选取清华大学附属北京市垂杨柳医院2012年12月至2015年6月间收治的10例肾出血并行SRAE术的患者，出血原因包括：经皮肾镜取石术(percutaneous nephrolithotomy，PCNL)、外伤性肾损伤；对患者进行肾动脉造影检查，确定出血部位及性质，微导管超选至出血动脉注入栓塞材料；通过血尿缓解、血红蛋白及血压变化来评价疗效。结果：PCNL术后出血5例，外伤性肾出血5例；单纯肾段动脉分支损伤出血7例，合并假性动脉瘤2例，假性动脉瘤合并动静脉瘘1例。10例患者均成功止血。1例PCNL合并动静脉瘘术后出血以及1例外伤性肾出血需要2次治疗达到止血目的。10例患者均未出现严重并发症。结论：SRAE是治疗肾出血的一种安全、有效的方法。
Clinical analysis of superselective renal artery embolization in 10 cases with renal hemorrhage
Objective: To evaluate the efficacy of superselective renal artery embolization in patients with renal hemorrhage. Methods: From December 2012 to June 2015, 10 patients with renal hemorrhage conducted SRAE were chosen in Beijing Chuiyangliu Hospital Affiliated to Tsinghua University. The causes of renal hemorrhage included percutaneous nephrolithotomy and traumatic kidney damage. Diagnostic renal artery angiography examination was performed in order to determine the bleeding sites and characters; embolization material was injected through a microcatheter to stop the bleeding. Clinical evaluation included remission of hematuria, hemoglobin and blood pressure. Results: Five patients were PCNL postoperative hemorrhage, the other five were traumatic renal hemorrhage; seven patients were simple renal artery branch injury bleeding, and two of them combined with false aneurysm, one of them was diagnosed with false aneurysm combined arteriovenous fistula (AVF). All patients achieved the purpose of hemostasis. One patient with AVF after PCNL and one patient with traumatic renal hemorrhage needed a second endovascular treatment to stop the bleeding. There were no serious complications in 10 cases after post-operation follow-up. Conclusion: SRAE is safe and effective in the treatment of renal hemorrhage.