目的探讨经皮微创肾镜取石及经皮肾穿刺活检术后肾出血的DSA表现及超选择性栓塞治疗的临床价值。资料与方法32例医源性肾出血患者,其中肾镜取石患者9例,肾穿刺术后出血23例,对肾出血动脉行超选择DSA,并用明胶海绵和(或)弹簧钢圈对其进行超选择性栓塞。回顾性分析其DSA表现,并观察超选择血管栓塞治疗肾出血的临床疗效。结果9例肾镜取石术后出血患者,5例表现为单纯性假性动脉瘤,4例表现为假性动脉瘤伴动静脉瘘;23例肾穿刺活检术后出血者,假性动脉瘤2例,对比剂外溢者8例,余13例表现为假性动脉瘤伴动静脉瘘。单独行明胶海绵颗粒栓塞20例,明胶海绵联合弹簧圈栓塞12例。术后患者出血停止,所有患者均有不同程度的栓塞反应,主要表现为发热及疼痛。结论DSA能明确医源性肾出血的诊断,超选择性动脉栓塞治疗医源性肾出血快速有效,并能最大程度地保护患者的肾功能,是医源性肾出血较为理想的治疗方法。 Objective To investigate the clinical manifestations of DSA after renal minimally invasive nephrolithotomy and percutaneous renal biopsy and the clinical value of superselective embolization. Materials and Methods 32 patients with iatrogenic renal hemorrhage, including 9 patients with nephrolithotomy, 23 patients with hemorrhage after renal puncture and DSA with renal artery hemorrhage, were treated with gelatin sponge and / or spring steel ring Superselective embolization. The clinical manifestations of DSA were retrospectively analyzed. The clinical efficacy of superselective thrombosis in the treatment of renal hemorrhage was observed. Results Nine patients had hemorrhage after nephrolithotomy, five had pseudoaneurysm, four had pseudoaneurysm with arteriovenous fistula, 23 had hemorrhage after renal biopsy, and had pseudoaneurysm 2 Cases, contrast agent spill in 8 cases, the remaining 13 cases showed pseudoaneurysm with arteriovenous fistula. 20 cases of gelatin sponge particles alone, 12 cases of gelatin sponge combined with coil embolization. Postoperative bleeding stopped, all patients have varying degrees of embolic reactions, mainly for fever and pain. Conclusion DSA can clearly diagnose iatrogenic hemorrhage. Superselective arterial embolization is rapid and effective in treating iatrogenic renal hemorrhage. It can also protect renal function of patients to the maximum extent and is an ideal treatment for iatrogenic renal hemorrhage.