Gupta M, Bellman G C, Smith A D
Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York, USA.
J Urol. 1997 Mar;157(3):795-7.
Although minor venous injuries respond to simple maneuvers, major venous injuries pose a significant therapeutic problem and may be under diagnosed. We present our experience with major injury to the renal vein during percutaneous renal surgery.
Four patients had massive hemorrhage during percutaneous renal surgery associated with major injury to the renal vein, and 3 also had renal insufficiency. All 4 patients and 1 additional patient with renal insufficiency and massive hemorrhage from an arteriovenous fistula following percutaneous renal surgery were treated nonoperatively with a selectively positioned and inflated Council balloon catheter.
Hemorrhage was controlled and renal function was unaffected in all 5 patients.
Renal vein injuries can be associated with massive hemorrhage. Patients with major vascular injuries from percutaneous renal surgery and concomitant renal insufficiency can be treated without open exploration or angiographic embolization using a Council balloon catheter.
尽管轻微静脉损伤可通过简单操作处理，但严重静脉损伤会带来重大治疗难题，且可能诊断不足。我们介绍经皮肾手术中肾静脉严重损伤的治疗经验。
4例患者在经皮肾手术期间发生大量出血，伴有肾静脉严重损伤，其中3例还存在肾功能不全。4例患者以及另外1例经皮肾手术后因动静脉瘘导致肾功能不全和大量出血的患者，均采用选择性放置并充盈的考克导管进行非手术治疗。
5例患者出血均得到控制，肾功能未受影响。
肾静脉损伤可能伴有大量出血。经皮肾手术导致严重血管损伤且伴有肾功能不全的患者，可使用考克导管进行治疗，无需开放探查或血管造影栓塞。
