肾包膜动脉栓塞联合超选择性肾动脉栓塞治疗损伤性肾出血  

Renal capsule artery embolization combined with superselective renal artery embolization in the treatment of traumatic renal hemorrhage

作　　者：石静 王龙胜[1] 杜临安[1] 谢军[2] 袁玉山 陈颍 SHI Jing;WANG Longsheng;DU Lin'an;XIE Jun;YUAN Yushan;CHEN Ying(Department of Radiology,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China;Department of Interventional Radiology,Fuyang People's Hospital of Anhui Medical University,Fuyang,Anhui Province 236000,China;Department of Emergency Surgery,Yuejiahu Hospital,Fuyang People's Hospital,Anhui Medical University,Fuyang,Anhui Province 236000,China)

机构地区：[1]安徽医科大学第二附属医院放射科,安徽合肥230601 [2]安徽医科大学附属阜阳人民医院介入放射科,安徽阜阳236000 [3]安徽医科大学附属阜阳人民医院岳家湖院区急诊外科,安徽阜阳236000

出　　处：《实用放射学杂志》2023年第9期1503-1505,1513,共4页Journal of Practical Radiology

基　　金：中国红十字基金会医学赋能-领航精英科研项目(XM-HRYXFN-2021-05-24)。

摘　　要：目的 探讨肾包膜动脉栓塞联合超选择性肾动脉栓塞术治疗损伤性肾出血(TRH)的有效性和安全性.方法 回顾性分析20 例TRH 患者的临床资料,使用肾包膜动脉栓塞术联合超选择性肾动脉栓塞术治疗,评价其对术后血红蛋白、肾功能及肾区疼痛视觉模拟评分的影响.结果 20 例均完成肾动脉造影,20 例行超选择性肾动脉栓塞联合肾包膜动脉栓塞,微弹簧圈栓塞肾动脉15 例,其中 4 例明胶海绵颗粒补栓塞肾动脉;5 例明胶海绵栓塞肾动脉;20 例明胶海绵颗粒栓塞肾包膜动脉.患者术后 7 d血肌酐水平较术前差异无统计学意义(P>0.05);术后血红蛋白、肾区疼痛视觉模拟评分较术前存在明显差异,有统计学意义(P<0.05).结论 肾包膜动脉栓塞联合超选择性肾动脉栓塞术是治疗TRH 安全、有效、微创的止血方法,值得推广.Objective To investigate the effectiveness and safety of renal capsule artery embolization combined with superselective renal artery embolization for the treatment of traumatic renal hemorrhage(TRH).Methods The clinical data of 20 patients with TRH were analyzed retrospectively,who were treated with renal capsule artery embolization combined with superselective renal artery embolization.Then the effects on postoperative hemoglobin,renal function,and visual analogue scale of pain in the renal area were evaluated.Results All 2o patients underwent successfully renal arteriography,and superselective renal artery embolization com-bined with renal capsule artery embolization including 15 cases with micro spring coil embolization of renal artery,of which 4 cases with adding of gelatin sponge pellet embolization,and other 5 cases with gelatin sponge embolization.The gelatin sponge pellet embo-lization of renal capsule artery was performed in all 20 cases.There was no statistically significant difference in the patients'blood creatinine level in 7 days after surgery compared with that before surgery(P>0.05);However,the statistically significant differ-ences in the postoperative hemoglobin and visual analogue scale of pain in the renal area were found compared with those before sur-gery(P<0.05).Conclusion Renal capsule artery embolization combined with superselective renal artery embolization is a safe,effective,and minimally invasive hemostatic method for the treatment of TRH and is worth promoting.

关 键 词：肾包膜动脉栓塞 肾动脉栓塞 损伤性肾出血 血尿 疼痛评分 

分 类 号：R815[医药卫生—放射医学] R692[医药卫生—临床医学]