介入栓塞治疗肾假性动脉瘤临床应用价值  

Clinical application value of interventional embolization in treating renal pseudoaneurysms

作　　者：张翔宇[1] 赵卫[1] 黄建强[1] 姜永能[1] 石潆[1] 

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《介入放射学杂志》2015年第5期379-382,共4页Journal of Interventional Radiology

基　　金：云南省应用基础研究面上项目(2011FZ122)

摘　　要：目的探讨介入栓塞术治疗肾假性动脉瘤（RAP）的临床应用价值及疗效。方法回顾性分析介入栓塞术治疗的11例RAP患者资料,术中分别采用普通弹簧圈、明胶海绵、聚乙烯醇（PVA）作为栓塞剂。术后随访6~24个月。结果 11例均为单发RAP,3例有出血征象。RAP位于肾上段1例,中段4例,下段5例,副肾动脉1例。单纯PVA栓塞1例,弹簧圈栓塞1例,PVA加弹簧圈栓塞1例,明胶海绵加弹簧圈栓塞8例。术后瘤体及造影剂外溢均消失,载瘤动脉呈残根样。术中患者均无明显不适,术后1周内2例出血患者血红蛋白、血细胞、红细胞压积明显升高。随访期间所有患者均无复发现象,尿常规正常。结论介入栓塞术是一种微创治疗RAP的方法 ,其安全可靠,能最大程度保护肾脏正常组织、挽救患者生命,值得推广。Objective To evaluate the clinical application and therapeutic effect of interventional embolization in treating renal pseudoaneurysms. Methods The clinical data of 11 patients with renal pseudoaneurysm, who had received interventional embolization management at authors’ hospital, were retrospectively analyzed. The embolic agents used in the embolization procedure included conventional steel coil, gelatin sponge particles, PVA, etc. All the patients were followed up for 6-24 months. Results Single renal pseudoaneurysm was found in all the 11 patients. Clinically, symptom of bleeding was seen in 3 cases. The renal pseudoaneurysm was located at the upper （n=1）, middle （n=4） and lower （n=5） renal artery of the kidney, and in one case the renal pseudoaneurysm was situated at the accessory renal artery. In performing renal artery embolization, pure PVA was used in one case, spring steel coil in one case, PVA together with spring steel coil in one case, and gelatin sponge combined with spring coil in 8 cases. After the embolization, the pseudoaneurysm was no more visualized, the contrast extravasation disappeared, and the parent artery was manifested as a residual root. During the operation the patients had no obvious discomfort. Within one week after embolization therapy, 2 patients developed hemorrhage, and their hemoglobin, white blood cell count and hematocrit were significantly increased. During the follow-up period, all patients showed no recurrence signs, and routine urine tests were normal. Conclusion For the treatment of renal pseudoaneurysms, interventional embolization is minimally-invasive, safe and reliable; this technique can maximally protect the normal kidney tissue, quickly control the bleeding and effectively save the life of patient. Therefore, it is worth promoting this treatment in clinical practice.

关 键 词：肾假性动脉瘤 介入栓塞 微创 

分 类 号：R692[医药卫生—泌尿科学] R816.7[医药卫生—外科学]