腔内技术治疗复杂性肾动脉瘤的临床疗效及安全性分析  

Analysis of clinical efficacy and safety of endovascular technique in treatmenting complex renal artery aneurysms

作　　者：黄东哲 陈亮 杨硕菲[1] 郭相江[1] 倪其泓[1] 陈佳佺[1] 王韦仑 张岚[1] 薛冠华[1] Huang Dongzhe;Chen Liang;Yang Shuofei;Guo Xiangjiang;Ni Qihong;Chen Jiaquan;Wang Weilun;Zhang Lan;Xue Guanhua(Department of Vascular Surgery,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院血管外科,上海200127

出　　处：《国际外科学杂志》2022年第7期452-456,共5页International Journal of Surgery

基　　金：国家自然科学基金面上项目(81873526)。

摘　　要：目的分析腔内技术治疗复杂性肾动脉瘤(RAA)的临床疗效及安全性。方法回顾性分析2014年11月—2021年9月上海交通大学医学院附属仁济医院收治的19例复杂性RAA患者的临床资料及随访结果。其中2例患者行单纯弹簧圈栓塞入瘤动脉治疗, 14例患者行单纯弹簧圈栓塞瘤腔治疗, 3例患者行支架辅助+弹簧圈栓塞技术治疗。依据瘤体位置将RAA分为Ⅰ、Ⅱ、Ⅲ型, 其中Ⅰ型7例, Ⅱ型10例, Ⅲ型2例。采用方差分析比较瘤体位于不同位置时患侧肾肾小球滤过率(GFR)的差异, 采用Pearson分析置入弹簧圈数与瘤体大小、GFR的相关性。结果 19例患者均成功进行腔内介入治疗。患者瘤体平均最大径为(20.89±6.65) mm, 平均置入弹簧圈为(8.22±3.08)枚。患者术前、术后血清肌酐值均处于正常范围, 且随访期间未见RAA瘤体增大或复发。Ⅰ、Ⅱ、Ⅲ型RAA患者术后患侧肾GFR存在不同程度异常, 3型患者间GFR比较差异具有统计学意义(P=0.003)。Ⅱ型RAA患者术后患侧肾GFR与置入的弹簧圈数目呈负相关(P=0.047), GFR与瘤体大小无显著关系。结论腔内技术治疗复杂性RAA安全可行, 初步临床疗效较满意。Objective To analyze the clinical efficacy and safety of endoluminal treatment of complex renal artery aneurysm(RAA).Methods The clinical data and follow-up results of 19 patients with complex RAA admitted to Renji Hospital,Shanghai Jiaotong University School of Medicine from November 2014 to September 2021 were retrospectively analyzed.Two patients were treated with simple spring coil embolization into the aneurysmal artery,14 patients were treated with simple spring coil embolization of the aneurysmal cavity,and 3 patients were treated with stent-assisted+spring coil embolization technique.Based on the location of the aneurysm,RAA were classified into typeⅠ,Ⅱ,andⅢ.7 patients with typeⅠ,10 patients with typeⅡ,and 2 patients with typeⅢwere studied.Variance analysis was used to compare the differences in glomerular filtration rate(GFR)of the affected side when the tumor was located at different locations,and Pearson was used to analyze the correlation between the number of coils implanted and the size of the tumor and GFR.Results Ten of the 19 patients who were underwent successful endoluminal intervention.The average size of the patients′aneurysms was(20.89±6.65)mm,and the average number of spring coils implanted was 8.22±3.08.The preoperative and postoperative serum creatinine were in the normal range,and no RAA tumor enlargement or recurrence was found during the follow-up period.The postoperative GFR was abnormal in patients with typeⅠ,typeⅡ,and typeⅢrenal aneurysms,and the mean GFR value differed among the three types of patients(P=0.003).There was a negative correlation between the postoperative GFR values of the affected kidney and the number of spring coils implanted(P=0.047),and no significant relationship between GFR and aneurysm size.Conclusion The endovascular technique is an effective and safe means of treating complex RAA.

关 键 词：肾动脉 动脉瘤 腔内技术 疗效 安全性 

分 类 号：R699.2[医药卫生—泌尿科学]