胡桃夹综合症的介入治疗  

Interventional therapy of nutcracker syndrome

作　　者：孙岩[1] 刘洋[1] 张十一[1] 袁海[1] 金星[1] 

机构地区：[1]山东大学附属省立医院血管外科,山东济南250021

出　　处：《医学影像学杂志》2011年第10期1509-1511,共3页Journal of Medical Imaging

基　　金：国家自然科学基金青年科学基金项目(81000186);山东省自然科学基金(Y2003C06)

摘　　要：目的:提高对胡桃夹综合征的认识,探讨NCS的腔内治疗。方法:回顾性分析山东大学附属省立医院血管外科2009年5月～2011年3月收治的4例胡桃夹综合症患者的临床资料,行左肾静脉腔内治疗。结果:4例患者均手术成功,肉眼血尿于7天后减轻,10～14天完全消失,镜下血尿15～30天完全消失。2例术前精索静脉曲张患者于术后3周消失;1例术前腰部不适症状患者术后2周消失;1例术前尿蛋白患者于术后2周恢复正常。随访(13±0.3)个月。症状均无复发,尿常规检查末见异常,B超检查:4例患者肾形态、血流灌注正常,肾静脉支架脉通畅。结论:血管腔内治疗微创、简单,术中准确测量、精确放置支架及术后严格抗凝治疗是治疗成功的关键和保证。Objective：To improve the understanding of nutcracker syndrome and to discuss the interventional treatment of nutcracker syndrome. Methods：Retrospective analysis of 4 cases of nutcracker syndrome hospitalized in vascular surgery department of Shandong Provincial Hospital from May 2009 to March 2011. 4 patients underwent balloon angioplasty and stent implantation in left renal vein. Results： All procedures were performed successfully in 4 patients. The macroscopic hematuria eased 7 days after surgery and disappeared completely within 14 days after surgery. The microscopic hematuria completely disappeared 15 to 30 days after surgery. 1 patient with varicocele completely recovered 3 weeks after surgery, and the patient suffering from flank pain completely eased 2 weeks after surgery. Proteinuria accompanied with another patients completely disappeared 2 weeks after surgery. All patients were followed up for 13±0.3 months. No clinical relapse occurred. Nothing unnormal was showed by routine urine alysis. The ultrasound showed patency of the stents and normal functioned kidneys. Conclusion： Compared with traditional surgery, interventional treatment is minimally invasive and easy to perform. The accurate location and deployment of stents and postoperative anticoagulation treatment are important to get satisfactory efficacy.

关 键 词：胡桃夹综合征 血管腔内治疗 支架 

分 类 号：R543[医药卫生—心血管疾病] R815[医药卫生—内科学]