超选择肾动脉栓塞治疗外伤性肾出血的临床应用  

Clinical application of superselective renal artery embolization in treatment of traumatic nephrorrhagia

作　　者：代向党 王赢 程喆 崔永强 

机构地区：[1]驻马店市中心医院放射科,河南驻马店463000

出　　处：《中国临床解剖学杂志》2009年第5期616-618,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的：探讨DSA下超选择。肾动脉插管栓塞治疗肾损伤出血的临床应用价值。方法：28例外伤性肾脏出血患者，采用Seldinger’s技术，先行肾动脉DSA造影，明确肾动脉主干或／和其分支损伤的部位及程度，在超滑导丝引导下超选择插管至出血动脉部位应用金属弹簧圈或明胶海绵颗粒进行栓塞治疗。结果：28例患者经DSA肾动脉造影后均能明确肾动脉出血的部位，经超选择插管金属弹簧圈或明胶海绵颗粒栓塞后均能有效止血，栓塞后造影显示出血动脉闭塞，造影剂外溢征象消失，术后1～3d肉眼血尿消失。结论：DSA下超选择肾动脉插管栓塞治疗肾出血创伤小、疗效好、并发症少，而且能最大限度的保护肾功能，是治疗外伤性肾出血的一种安全、快捷、有效的方法。Objective： To investigated of clinical effectiveness of renal artery embolotherapy with DSA-guided superselective catheterization on the treatment of traumatic nephrorrhagia. Methods： Renal arteries of 28 patients with traumatic nephrorrhagia were visualized firstly using Seldinger＇s technology to identify location and extent of damage of renal artery trunk or / and its branch. Secondly, super-slide wire-guided superselective catheterization was applied to get to the bleeding artery, which was embolized with metal coils or gelatin sponge particles. Results： The sites of bleeding can be identified with DSA-guided renoarteriography Jn all cases. Embolotherapy with metal coils or gelatin sponge particles by superselective catheterization could effectively stop bleeding. Angiography after embolization showed that bleeding artery obliterated, without contrast agent spillover signs and gross hematuria 1-3d after operation. Conclusion： Renal artery embolotherapy with DSA-guided superselective catheterization is valuable for protecting renal functions.

关 键 词：肾出血 肾动脉栓塞 

分 类 号：R322.61[医药卫生—人体解剖和组织胚胎学] R605.972[医药卫生—基础医学]