创伤性肾动脉栓塞的临床特点及治疗  

Clinical characteristics and treatment of traumatic renal artery thrombosis

作　　者：李广永[1] 高裕[1] 张超[1] 杨晓波[1] 吴海峰[1] 李培军[1] 陈福宝[1] Li Guangyong;Gao Yu;Zhang Chao;Yang Xiaobo;Wu Haifeng;Li Peijun;Chen Fubao(Department of Urology,General Hospital of Ningxia Medical University,Yinchuan 750004,Chin)

机构地区：[1]宁夏医科大学总医院泌尿外科,银川750004

出　　处：《中华老年医学杂志》2018年第8期901-903,共3页Chinese Journal of Geriatrics

摘　　要：目的 探讨创伤性肾动脉栓塞的临床特点、早期诊断和治疗方法. 方法 总结10例创伤性肾动脉栓塞患者的临床资料. 结果 左肾动脉栓塞6例,右肾动脉栓塞4例.1例B超提示肾脏血流信号减少,增强CT证实.其余9例均增强CT扫描发现肾动脉栓塞.4例单纯创伤性肾动脉栓塞患者给予低分子肝素钙溶栓治疗.随访CT检查栓塞肾没有明显的血液灌注,但肾功能均在正常范围.2例患者出现肾性高血压,其中1例药物血压控制不良,行肾切除. 结论 创伤性肾动脉栓塞的临床症状和实验室检查无特异性,彩色超声可能为其早期诊断方法,增强CT检查是其有效的确诊手段.早期恢复栓塞肾的血运是其有效的治疗措施,随访关注患者肾功能和血压变化.Objective To investigate the clinical characteristics,early diagnosis,and rational treatments of traumatic renal artery thrombosis or other traumatic emboli.Methods We summarized the clinical data of 10 patients with traumatic renal artery thrombosis or other traumatic emboli.Results Six of ten patients had left renal artery thrombosis,while four of the ten patients had right renal artery thrombosis.Ultrasonography reported a reduced blood flow signal in one patient,and then renal artery embolism was confirmed by enhanced CT.The other nine patients were directly definitely diagnosed as renal artery embolism by enhanced CT.Four patients were treated with low molecular weight heparin calcium,in whom the CT follow-up showed no obvious blood reperfusion in injured kidneys,but the renal function was in normal range.Renal hypertension occurred in two patients,and one of them received nephrectomy because of poorly controlled hypertension with medication.Conclusions Clinical symptoms,signs and laboratory examinations show no specific findings for diagnosis of traumatic renal artery thrombosis.The color Doppler ultrasound is a preliminary screening method for,and an enhanced CT scan is an effective method for,diagnosis of renal artery thrombosis.The early recovery of renal blood circulation is an evidence of effective treatment.Major concerns are supposed to focus on renal function and blood pressure during followup.

关 键 词：钝器伤 肾蒂损伤 创伤性肾动脉栓塞 

分 类 号：R699.2[医药卫生—泌尿科学]