超选择性肾动脉栓塞治疗肾损伤出血（附72例报告）  

The Treatment of Traumatic Renal Hemorrhage with Superselective Renal Artery Embolization： A Report of 72 Cases

作　　者：王家平[1] 柯昌兴[2] 李迎春[1] 袁曙光[1] 闫东[1] 王剑松[2] 童玉云[1] 朱全胜[1] 曾俞霖[2] 

机构地区：[1]昆明医学院第二附属医院放射科,云南昆明650101 [2]昆明医学院第二附属医院泌尿外科,云南昆明650101

出　　处：《实用放射学杂志》2009年第6期873-875,共3页Journal of Practical Radiology

摘　　要：目的探讨超选择性插管肾动脉栓塞治疗肾损伤出血的临床应用价值。方法72例肾脏损伤出血患者，采用Seldinger技术，经肾动脉造影明确动脉损伤的部位及程度后，行超选择性插管至出血的肾动脉分支，用明胶海绵或金属弹簧圈进行栓塞。结果57例闭合性肾损伤1次栓塞后血止53例，2例栓塞后休克得以控制，顺利实施了手术，另2例栓塞后再发出血，经第2次栓塞血止。5例开放性肾损伤和10例医源性肾损伤均经1次栓塞后血止。随访6～72个月，无血尿复发、脓肾、肾性高血压病例。结论超选择性肾动脉栓塞术，对不同类型的肾损伤出血是一种迅速有效止血手段。Objective To evaluate the clinical application of superselective renal artery embolization（SRAE} in treatment of traumatic renal hemorrhage. Methods 72 patients with traumatic renal hemorrhage were first demonstrated by renal arterigraphy under seldinger technique to ensure the rapture site and traumatic degree of renal artery,and then followed by percutaneous cathetherized superselective renal arterial embolization with gelatin sponges or steel coils. Results Of 72 cases, 57 patients with closed renal trauma were cured by once SRAE, 2 patients with shock were received successfully open operation after SRAE, bleeding again after SRAE in 2 cases were cured by second SRAE. 5 patients with open renal trauma and 10 patients with iatrogenic renal trauma were cured by once SRAE . There was no recurrent hemorrhage , pyonephrosis , or renal hypertension occurred during followed--up for 6~72 months. Conclusion Superselective renal arterial embolization is effective therapeutic method for different types of traumatic renal hemorrhage.

关 键 词：创伤 肾脏 血管造影术 介入放射学 

分 类 号：R692[医药卫生—泌尿科学] R814.43[医药卫生—外科学]