超选择性肾动脉栓塞术治疗不同原因急性肾出血的疗效分析  

Efficacy analysis of superselective renal artery embolization in the treatment of different causes of acute renal hemorrhage

作　　者：朱辉 倪才方[2] Zhu Hui;Ni Caifang(Department of Radiology,Suzhou Wuzhong People′s Hospital,Jiangsu 215128,China;不详)

机构地区：[1]江苏省苏州市吴中人民医院放射科,215128 [2]苏州大学附属第一人民医院介入科

出　　处：《实用医学影像杂志》2024年第2期124-127,共4页Journal of Practical Medical Imaging

摘　　要：目的 探讨超选择性肾动脉栓塞术(SRAE)治疗不同原因急性肾出血的疗效和安全性。方法 回顾分析2016年1月至2021年12月129例不同原因急性肾出血患者的临床资料,以术中复查造影相关出血征象消失定义技术成功,出血停止且无再次出血定义临床成功;根据出血原因分为非医源性肾出血组(49例)和医源性肾出血组(80例),统计并比较2组患者的栓塞疗效和安全性。结果 本组共纳入129例患者,栓塞技术成功率100%,首次临床成功(出血停止)121例,成功率93.8%,再次出血8例,其中5例进行二次栓塞,均成功停止出血。2组患者性别、年龄、手术时间、技术成功率、临床成功率及栓塞后综合征比较,差异无统计学意义(P>0.05);2组患者治疗后血红蛋白水平与本组治疗前比较,差异具有统计学意义(P<0.05);2组患者治疗前血红蛋白水平、治疗后血红蛋白水平、治疗前血尿素氮、治疗后血尿素氮、治疗前血肌酐比较,差异均具有统计学意义(P<0.05),但治疗后较治疗前血红蛋白水平差值(即栓塞疗效)、治疗后较治疗前血尿素氮及血肌酐差值(即栓塞后肾功能水平变化)比较,差异无统计学意义(P>0.05)。结论 超选择性肾动脉栓塞术对不同原因导致的急性肾出血止血效果显著,无治疗相关严重并发症发生,术后再出血发生率低。对保守治疗无效的急性肾出血患者,可作为首选治疗方法。Objective To investigate the efficacy and safety of superselective renal artery embolization(SRAE)in the treatment of different causes of acute renal hemorrhage.Methods The clinical data of 129 patients with acute renal hemorrhage of different causes from January 2016 to December 2021 were retrospectively analyzed,and the definition of clinical success was defined as the disappearance of angiographic bleeding,cessation of bleeding,and no recurrence during intraoperative review.According to the causes of bleeding,the patients were divided into the non-iatrogenic renal hemorrhage group(n=49)and the iatrogenic renal hemorrhage group(n=80).The efficacy and safety of embolization were compared between the two groups.Results A total of 129 patients were included in this group.The success rate of the embolization technique was 100%,121 cases were successful(bleeding stop)for the first time,the success rate was 93.80%.eight cases were bleeding again,5 cases were embolized for the second time,and the bleeding was stopped successfully.There were no significant differences in gender,age,operation time,clinical success rate,and embolism syndrome between the non-iatrogenic renal hemorrhage group and the iatrogenic renal hemorrhage group(P>0.05).The hemoglobin levels of the two groups after treatment were compared with those before treatment,the differences were statistically significant(P<0.05).There were statistically significant differences in hem-oglobin level before treatment,hemoglobin level after treatment,blood urea nitrogen before treatment,blood urea nitrogen after treatment,and serum creatinine before treatment between the two groups(P<0.05),but there was no significant difference in the difference of hemoglobin level(the efficacy of embolization),blood urea nitrogen and serum creatinine level(the change of renal function after embolization)between before and after treatment(P>0.05).Conclusion Super selective renal artery embolization has a remarkable hemostatic effect on acute renal hemorrhage caused by different r

关 键 词：急性肾损伤 超选择性肾动脉栓塞术 疗效 安全性 

分 类 号：R692[医药卫生—泌尿科学] R445.1[医药卫生—外科学]