选择性肾动脉栓塞治疗损伤性肾出血  

Super-selective renal artery embolization for the treatment of traumatic renal hemorrhage

作　　者：段跃[1,2] 徐庆康[3] 周涛[4] 于田强[2] 洪翔[2] 孙先军[2] 杨益[2] 李晓强[1] 

机构地区：[1]苏州大学附属第二医院血管外科,江苏苏州215004 [2]武警浙江省总队医院泌尿外科 [3]武警浙江省总队医院泌尿外 [4]武警浙江省总队医院介入中心科

出　　处：《介入放射学杂志》2013年第3期231-234,共4页Journal of Interventional Radiology

摘　　要：目的 观察选择性肾动脉栓塞治疗急性损伤性肾出血的疗效。方法 回顾性分析2008年6月—2011年12月32例损伤性肾出血行选择性肾动脉栓塞治疗情况，其中包括肾挫裂伤18例，肾部分切除术术后出血2例，经皮肾镜术后出血12例。结果 31例患者一次栓塞成功，1例患者栓塞术后第5天再次出血行第2次栓塞术后血尿消失。术后随访2 ～ 40个月，未见肾出血再发，1例出现肾周尿液囊肿；2例肾脏体积缩小，该2例均为Ⅴ级肾挫裂伤患者。随访期间无肾脓肿、肾性高血压及肾功能异常发生。结论 选择性肾动脉栓塞是治疗急性损伤性肾出血微创、有效、安全的治疗方法。Objective To investigate the clinical effect of super-selective renal artery embolization for the treatment of traumatic renal hemorrhage. Methods During the period from June 2008 to December 2011 at authors＇ hospital super-selective renal artery embolization was carried out in 32 patients with renal injury hemorrhage. The causes of traumatic renal hemorrhage included renal contusion （n = 18）, partial nephrectomy （n = 2） and percutaneous nephrolithotomy （n = 12）. The clinical results were analyzed. Results Technical success with single procedure was achieved in all patients. One patient developed recurrent bleeding five days after the embolization procedure, then renal artery embolization had to be carried out again, and the hematuria disappeared soon after the second procedure. All patients were followed up for 2 - 40 months. During the follow-up period, no recurrence of renal hemorrhage was seen. Perinephric urinoma was detected on CT scanning in one case. In two cases with severe renal injury （grade V ） the kidney decreased in size after the embolization.Neither renal abscess nor renal hypertension or renal dysfunction occurred. Conclusion For the treatment of acute traumatic renal hemorrhage, super-selective renal artery embolization is a safe, minimally-invasive and very effective therapy.

关 键 词：肾脏 肾动脉 栓塞 创伤和损伤 出血 

分 类 号：R692[医药卫生—泌尿科学]