医源性肾损伤出血的介入栓塞治疗分析  

Analysis of interventional embolization in treatment of iatrogenic renal injury hemorrhage

作　　者：孙陵[1] 王书祥[1] 王福安[1] 吕朋华[1] 

机构地区：[1]江苏省苏北人民医院介入放射科,225001

出　　处：《齐齐哈尔医学院学报》2013年第17期2523-2524,共2页Journal of Qiqihar Medical University

摘　　要：目的探讨介入栓塞治疗在医源性肾损伤出血治疗中的价值。方法对12例医源性肾损伤出血患者（肾穿刺活检后3例,肾结石切开取石4例,经皮肾镜取石5例）行肾动脉造影,根据造影情况,超选择插管至出血部位,用明胶海绵和/或金属弹簧圈或微弹簧圈栓塞治疗。结果 12例肾出血部位均为肾段和段以下肾动脉分支,其中肾段动脉4例,段以下分支动脉8例。造影表现：假性动脉瘤4例,动-静脉瘘3例,造影剂外溢5例。单纯明胶海绵颗粒栓塞5例,单纯弹簧圈栓塞6例,明胶海绵联合弹簧圈栓塞1例。11例患者术后2~4天肉眼血尿消失,1例术后3天再出血者,再次栓塞后血尿消失。12例患者随访3~12个月,均无复发和并发症发生。结论介入栓塞治疗医源性肾损伤出血是一种创伤小,迅速、安全、有效的止血方法,且能最大限度保护肾功能。Objective To investigate the effect of interventional embolization in the treatment of traumatic hemorrhage in iatrogenic renal.Methods Twelve patients with hemorrhage in iatrogenic renal（renal biopsy of 3 cases,renal stones lithotomy 4 cases and percutaneous nephrolithotomy 5 cases） were retrospectively analyzed.Super selective catheterization to the bleeding site and embolization with gelfoam and / or steel coils or microcoils were carried out after renal artery angiography in this study.Results Renal hemorrhage located at the segmental renal artery of 4 cases and following segmental artery of 8 cases.Renal arterial angiogram revealed pseudoaneurysms in 4 cases,arteriovenous fistula 3 cases and contrast agent extravasation 5 cases.Of the 12 cases,5 were treated with gelfoam,6 with coils and 1 with gelfoam combined coils.The naked eye hematuria disappeared after procedure in 11 patients within 4 days.1 patient received re-embolization for postoperative rebleeding 3 days later and achieved a good clinical effect.None of the patients had recurrence and complications during follow-up（range,3 ~ 12months）.Conclusions Interventional embolization in the treatment of iatrogenic renal hemorrhage is a small-wounded,rapid,safe,effective method to stop bleeding,and can maximize the protection of renal function.

关 键 词：医源性肾损伤 出血 介入栓塞 

分 类 号：R581.1[医药卫生—内分泌]