摘要
目的总结经皮肾穿刺活检术后出血的原因、出血的高危因素及其治疗经验。方法回顾性分析皖南医学院弋矶山医院2009年4月—2013年4月共215例B超引导下行肾穿刺活检术的患者临床资料及总结肾穿刺活检术后出血病例的临床特点,并列举2例大出血病例的临床治疗方案及病情演变情况,探讨肾穿刺活检术后出血的最佳救治方案。结果 215例中术后肉眼血尿患者12例肉眼血尿患者经卧床休息,血凝酶、止血三联、卡络磺钠等药物治疗后均在1周内肉眼血尿消失,均转为镜下血尿,2例患者穿刺术后出现大出血,该2例患者术前均有高血压病史,其中1例术前口服糖皮质激素治疗长达2月,以上2例患者经肾动脉介入栓塞治疗止血,生命体征迅速稳定,术后肾功能恢复至术前状态。结论肾穿刺活检后8 h内为出血的高危期,术前高血压病史、服用糖皮质激素是肾活检后大出血的高危因素,一般止血治疗常可达到目的,肾动脉介入栓塞是肾穿刺活检术后大出血治疗的最佳方法,其安全性高,可达到较好的止血效果。
Objective To evaluate the reason and the treatment of severe hemorrhage following renal biopsy. Methods215 cases of Renal Biopsy were studied to find the most effective therapy method,2 cases with severe renal bleeding after kidney biopsies performed under real-time ultrasonograph guidance were studied. The clinical material were reviewed,the risk factors were analyzed,and different therapy methods were compared. Results Among the 215,12 cases had gross hematuria,after staying in bed and hemostatic treatment for a week or less,they all turned into microscopic hematuria,2 patients with severe hemorrhage were cured by selective renal arterial rmbolization. They had hypertension history and case 2had been taking glucocorticoid for 2 months,their renal function remained stable. Conclusion 8 hours after Renal biopsy was the most risky time slot,hypertension history and taking glucocorticoid were risk factors for severe hemorrhage after renal biopsy,general hemostatic treatment often can achieve,selective renal arterial embolization was the most effective treatment.
出处
《中华全科医学》
2014年第10期1568-1569,1671,共3页
Chinese Journal of General Practice
