肾动脉栓塞治疗肾脏疾病(附21例分析)  

Renal artery embolization for the treatment of renal disease

作　　者：芦志刚[1] 方军[1] 余洪涛[1] 琚建军[1] 张勋初[1] 龚强[1] 

机构地区：[1]铜陵市人民医院,安徽铜陵244000

出　　处：《井冈山医专学报》2005年第2期11-12,共2页Journal of Jinggangshan Medical College

摘　　要：目的研究肾动脉栓塞对肾肿瘤、肾脓肿和肾出血性疾病的治疗意义。方法采用seldinger法经皮穿刺行股动脉插管,术前辅助肾动脉栓塞治疗肾癌11例和肾脓肿1例,栓塞后2～7天行手术治疗。4例晚期肾癌行肾动脉内化疗加栓塞治疗,4例外伤性肾破裂和1例肾结石术后严重持续血尿,采用明胶海绵或(和)自体血凝块栓塞治疗。结果11例肾癌和1例肾脓肿栓塞后体积缩小,易于切除,术中出血少,无手术并发症。姑息性肾动脉内化疗加栓塞治疗病人疼痛、血尿明显改善,肿块明显缩小。4例晚期肾癌治疗后2例己存活3年以上。9例肾出血性疾病除1例改行开放手术外,余均经栓塞治愈。随访1个月～7年,2例有肾萎缩,其余均正常。结论肾动脉栓塞是治疗肾疾病的一种安全、有效的方法。并发症少,能最大限度保留肾脏。肾动脉内化疗加栓塞安全有效,可用于术前肾癌辅助治疗及晚期肾癌的姑息治疗。Objective:To tudy the efficacy of renal ertery e mbolization for renal neoplasms,ab cesses and bleeding.Methods:11cases of renal carcinomas and 1 cases of abcesses were all teated with se lective renal artery embolization b ef ore surgery and4cases of advanced renal carcinomas were treated with selective renal artery chemo -embolization.5of traum atic renal hemor-rhages were trea ted with renal segme nt artery embolization.embolization materials for hemorrha ges were ma inly self -blood clots and(or)gelfoam.Results:The sizes of carc inomas and abcesses were decreased in all of 11cases of re nal carcinomas and 1cas-esof renal abcesses.the renal artery embolization made resection easie r .and bleeding was reduced,the symp tom was improved.the patients of transar t erial chemo -em bolization have been improved evidently in the near future.all the renal bleeding were cured with renal artery ambolization exce pt for one tr aumatic case treated by o peration for continuous bleeding.A ll these cases wer e followed up for 1month to 7years,1cases had atrophy of kidney and all the o thers were in good condition.Conclusions:Renal artery embolzation is a safe effective approach with less complications and most probability to preserve the diseased kidneys.the trans arterial chemo embolization i s safe and effective m ethods in the au xiliary preoperative treatment of r enal cell carcinoma and th e treatment of unresctable RCC.

关 键 词：肾肿瘤 出血 栓塞 治疗 

分 类 号：R605[医药卫生—外科学] R692[医药卫生—临床医学]