关键词: 逆行肾内输尿管软镜手术, 肾包膜下血肿, 病例分析

Abstract: Objective To explore the diagnosis and treatment of delayed renal subcapsular hematoma(DRSH) after retrograde intrarenal surgery(RIRS) for renal calculi and related factors. Methods Case data of 2 patients with DRSH after RIRS were retrospectively analyzed.The preoperative general situation,operative situation,diagnosis and treatment of subcapsular hematoma were evaluated.Results RIRS were performed successfully in 2 cases with renal calculi and the operation time were 55 min and 38 min respectively.Both patients were indwelled with F6 ureteral double J stent.Postoperative hemostasis and antibiotics were used.Postoperative re-examination of urinary ultrasound or CT showed no abnormalities and the patients were discharged,and the double J stent were removed 4 weeks and 2 weeks after operation respectively.One case developed DRSH more than 1 month after operation and the other one more than 2 weeks after operation.After hemostasis and anti-infection treatment,the hematoma in 2 cases were absorbed within more than 1 month and more than 5 months respectively.Conclusion DRSH may occur in the treatment of renal calculi by RIRS.The combination of basic diseases such as hypertension or diabetes,old age,the use of anticoagulant drugs may be some of the factors leading to DRSH.For patients with complete renal capsule and no combined infection,conservative treatment such as hemostasis and anti-infection should be given,and the hematoma can be gradually absorbed.

Key words: retrograde intrarenal surgery, renal subcapsular hematoma, case analysis