Katz R, Admon D, Pode D
Department of Urology, Hadassah University Hospital, Jerusalem, Israel.
J Endourol. 1997 Feb;11(1):23-5. doi: 10.1089/end.1997.11.23.
Extracorporeal shock wave lithotripsy, the primary treatment for renal and ureteral stones, is an elective procedure with a low rate of complications, although most patients have macrohematuria which lasts for a few hours, and as many as 25% develop a renal or perirenal hematoma. Therefore, SWL is not performed during anticoagulant therapy, and any blood dyscrasias should be corrected prior to the procedure. We present a case of a patient who had an acute myocardial infarction after SWL, was treated with anticoagulation and emergency coronary angioplasty, and subsequently developed a life-threatening retroperitoneal hemorrhage. Cessation of anticoagulation with fluid support and drainage of a pleural effusion eventually resulted in complete recovery.
体外冲击波碎石术是肾和输尿管结石的主要治疗方法，是一种并发症发生率较低的选择性手术，尽管大多数患者会出现持续数小时的肉眼血尿，多达25%的患者会出现肾或肾周血肿。因此，在抗凝治疗期间不进行体外冲击波碎石术，并且在手术前应纠正任何血液系统异常。我们报告一例患者，其在体外冲击波碎石术后发生急性心肌梗死，接受抗凝治疗和急诊冠状动脉血管成形术，随后出现危及生命的腹膜后出血。停止抗凝并给予液体支持及胸腔积液引流最终使其完全康复。
