Nursing experience with the delayed hemorrhage occurring after percutaneous nephrolithotomy and treated with interventional segmental renal artery embolization

Objective: To discuss the key points of nursing care for patients with delayed hemorrhage which occurs after percutaneous nephrolithotomy and is treated with interventional segmental renal artery embolization. Methods: During the period from Jan. 2005 to Jan. 2013 at authors, hospital, a total of 816 patients with renal and upper ureteral stones received percutaneous nephrolithotomy. The clinical data were retrospectively analyzed. A total of 1 623 times of percutaneous nephrolithotomy were carried out in 816 patients. After the treatment persistent or intermittent hematuresis occurred in 26 patients, of whom interventional segmental renal artery embolization was employed in 13. The optimal time for interventional management and the key points of nursing care were analyzed. Results: Digital subtraction angiography demonstrated that renal pseudoaneurysm was found in 4 cases, renal arteriovenous fistula in 3 cases and renal pseudoaneurysm accompanied by arteriovenous fistula in 6 cases. Interventional segmental renal artery embolization was carried out in all the 13 patients. Postoperative renal angiography performed 15 minutes after the embolization showed that the bleeding artery was completely obstructed in all patients. The hematuresis disappeared completely in 2-5 days after the treatment in all patients, and the patients were discharged from hospital in 5-7 days with a full recovery. Conclusion: Interventional segmental renal artery embolization is an effective and reliable treatment for the delayed renal hemorrhage occurring after percutaneous nephrolithotomy. Strict accomplishment of all perioperative nursing measures is the key point to ensure a successful therapy. (authors)