Krishnamurthi V, Streem S B
Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
J Urol. 1995 Nov;154(5):1673-5.
We determined the long-term radiographic and functional outcome of extracorporeal shock wave lithotripsy (ESWL) related perirenal hematomas.
We followed 19 patients with 21 ESWL induced hematomas for 4 to 61 months (mean 19.6) after ESWL with serial ultrasound, blood pressure and serum creatinine determinations.
Complete radiographic resolution of the hematoma was evident in 18 cases (85.7%), while 2 (9.5%) were significantly smaller and 1 (4.8%) remained unchanged. Of 10 patients who were normotensive before ESWL none experienced sustained new onset hypertension. Of 9 patients with preexisting hypertension none had a sustained exacerbation. Finally, during followup serum creatinine levels overall remained unchanged from pre-ESWL values.
We conclude that, by far, the most likely outcome for patients with ESWL related hematomas is spontaneous radiographic resolution within 2 years without clinically evident adverse effects on blood pressure or renal function.
我们确定了体外冲击波碎石术（ESWL）相关肾周血肿的长期影像学和功能转归。
我们对19例患者的21处ESWL诱发的血肿进行了随访，在ESWL后4至61个月（平均19.6个月），定期进行超声检查、测量血压并检测血清肌酐。
18例（85.7%）血肿在影像学上完全消退，2例（9.5%）明显缩小，1例（4.8%）无变化。ESWL前血压正常的10例患者中，无1例出现持续性新发高血压。9例原有高血压的患者中，无1例病情持续加重。最后，在随访期间，血清肌酐水平总体上与ESWL前的值相比无变化。
我们得出结论，迄今为止，ESWL相关血肿患者最可能的转归是在2年内血肿自行在影像学上消退，且对血压或肾功能无明显临床不良影响。
