医源性肾动脉损伤的介入治疗  

Interventional treatment of iatrogenic renal artery injury

作　　者：滕红[1] 陈世沛[1] 徐兴明[1] 陈友琼[1] 赵张平[1] 谢英[1] 

机构地区：[1]攀枝花市中心医院放射科,四川攀枝花617067

出　　处：《四川医学》2013年第10期1579-1580,共2页Sichuan Medical Journal

摘　　要：目的回顾性分析超选择性肾动脉栓塞在治疗医源性肾动脉损伤的临床应用价值,探讨医源性肾动脉损伤的介入诊疗规程。方法经皮肾镜取石术后大出血患者28例,采用Seldinger技术经股动脉插管,先行腹主动脉造影后,将导管选择至受损肾行肾动脉造影,确定出血动脉,行超选择性栓塞治疗;术后观察疗效及并发症。结果 27例患者肾动脉造影呈阳性,其中假性动脉瘤15例,动静脉瘘7例,造影剂外溢4例,血管中断1例,行超选择性受损动脉分支栓塞均成功,术后出血停止;1例肾动脉造影呈阴性,术中肾动脉狭窄、大量血栓形成,致使手术中途停止,术后再次大量出血,行急诊肾脏探查及修补术后止血成功。所有患者未出现严重并发症。结论超选择性肾动脉栓塞治疗医源性肾动脉损伤出血,安全、高效,值得临床广泛推广:规范的诊疗路径是治疗成功的保证。Objective Retrospective analysis of the super-selective renal arterial embolization explore clinical value in the treatment of iatrogenic renal artery injury iatrogenic renal artery injuries interventional procedures. Methods 28 cases of the per- cutaneous nephrolithotomy stone postoperative bleeding. Seldinger technique through the femoral artery catheter, first abdominal aortic angiography catheter choose to impaired kidney renal angiography to determine the bleeding artery, line of super-selective embolization therapy. Postoperative efficacy and complications were obserred. Results 27 patients with renal artery angiography were positived, including 15 cases of pseudoaneurysm, arteriovenous fistula 7 cases, contrast extravasation 4 cases, vascular inter- rupt 1 cases, implementation of the super-selective the damaged arterial branch embolization were successful postoperative bleeding stoppe ; 1 cases of renal artery angiography was negative, intraoperative renal artery stenosis, and a lot of thrombosis, resulting in surgical midway stop, postoperative massive bleeding again, by emergency kidney exploration and after repair hemostasis. There were no serious complications. Conclusion Super-selective renal artery embolization iatrogenic renal artery injury hemorrhage, safe, efficient and worthy of extensive promotion; standard treatment path might be the guarantee of treatment success.

关 键 词：肾动脉 出血 栓塞 介入治疗 

分 类 号：R692[医药卫生—泌尿科学]