Zagoria R J, Hodge R G, Dyer R B, Routh W D
Department of Radiology, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, North Carolina 27157-1088.
J Urol. 1993 Jun;149(6):1449-51. doi: 10.1016/s0022-5347(17)36412-1.
Six patients with severe hemorrhagic cystitis unresponsive to traditional localized therapy were treated with percutaneous nephrostomy for diversion of urine. Bladder hemorrhage ceased in 3 patients, decreased in 2 and was unchanged in 1. In 1 patient with profound thrombocytopenia perirenal hematoma developed as a result of the nephrostomy placement but this complication was self-limited and did not require surgery. Our experience with these 6 patients indicates that nephrostomy diversion is safe and effective in most cases of hemorrhagic cystitis refractory to traditional, nonoperative therapy. Percutaneous urine diversion may obviate the need for surgical urinary diversion in patients who have intractable hemorrhagic cystitis.
6例对传统局部治疗无反应的严重出血性膀胱炎患者接受了经皮肾造瘘术以引流尿液。3例患者膀胱出血停止，2例出血减少，1例无变化。1例严重血小板减少症患者因放置肾造瘘管出现肾周血肿，但该并发症为自限性，无需手术。我们对这6例患者的经验表明，在大多数对传统非手术治疗无效的出血性膀胱炎病例中，肾造瘘引流是安全有效的。经皮尿液引流可避免对患有顽固性出血性膀胱炎的患者进行外科尿液改道。
