超选择性肾动脉栓塞治疗巨大型肾血管平滑肌脂肪瘤  

Super-selective renal arterial embolization in treating huge renal angiomyolipoma

作　　者：王承恩 范则杨 杨敏[1] 佟小强[1] 王健[1] 关海涛[1] 宋莉[1] 邹英华[1] WANG Cheng＇en;FAN Zeyang;YANG Min;TONG Xiaoqiang;WANG Jian;GUAN Haitao;SONG Li;ZOU Yinghua(Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院介入血管外科,北京100034

出　　处：《中国介入影像与治疗学》2018年第6期327-330,共4页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的评价超选择性肾动脉栓塞(SRAE)治疗巨大型肾血管平滑肌脂肪瘤(RAML)的临床疗效及安全性。方法回顾性分析16例接受SRAE治疗且临床资料完整的巨大型RAML患者的资料,对比分析治疗前后患者临床症状、肿瘤大小、肾功能变化及并发症情况。结果对16例患者共进行26次SRAE治疗,技术成功率100%(26/26);其中1次治疗7例(7/16,43.75%),2次治疗8例(8/16,50.00%),3次治疗1例(1/16,6.25%)。治疗后平均随访(16.60±15.60)个月。至末次随访复查时,瘤体最大径[(9.00±2.80)cm]较治疗前[(12.60±2.40)cm]明显缩小(t=12.41,P<0.01),SRAE治疗后患者腰痛、血尿症状均好转,肌酐水平[(79.10±12.80)μmol/L]与治疗前[(76.00±14.90)μmol/L]差异无统计学意义(t=0.89,P=0.39)。14例(14/16,87.50%)SRAE治疗后1~3天出现不同程度发热、局部疼痛或恶心等症状,无严重并发症发生。结论 SRAE可有效控制巨大型RAML破裂出血,缓解RAML相关临床症状,同时可在较大程度上保留正常肾单位。Objective To evaluate the efficacy and safety of super-selective renal arterial embolization（SRAE）for treatment of huge renal angiomyolipoma（RAML）.Methods Data of 16 patients with huge RAML treated with SRAE were retrospectively analyzed.The clinical symptoms,tumor size,serum creatinine and complications were compared before and after SRAE.Results A total of 26 SRAE treatments were performed on 16 patients with huge RAML.The technical success rate of SRAE was 100%（26/26）.Seven cases（7/16,43.75%）received one SRAE treatment,whereas8（8/16,50.00%）required two SRAE treatments.Only one case（1/16,6.25%）received three SRAE treatments.The mean follow-up period was（16.60±15.60）months.The maximum diameter of the tumor reduced significantly after SRAE at final follow-up than before embolization（[9.00±2.80]cm vs[12.60±2.40]cm,t=12.41,P〈 0.01）.The symptoms of flank pain and hematuria gradually relieved after SRAE.And there was no statistical difference of mean serum creatinine before and after SRAE（[76.00±14.90]μmol/L]vs[79.10±12.80]μmol/L,t=0.89,P=0.39）.Fourteen cases（14/16,87.50%）experienced post-embolization syndrome including varying degrees of fever,local pain or nausea on 1—3 days after embolization.No serious complications occurred.Conclusion SRAE is an effective method for stopping bleeding of ruptured huge RAML,as well as relieving symptoms and reserving nephron.

关 键 词：血管平滑肌脂肪瘤 栓塞 治疗性 治疗结果 并发症 

分 类 号：R737.11[医药卫生—肿瘤] R815[医药卫生—临床医学]