摘要
目的探讨超选择性动脉栓塞在医源性损伤导致的肾岀血中的应用价值。方法 2009年12月至2012年2月收治11例医源性损伤导致的肾岀血患者,其中肾造瘘术后出血3例,经皮肾镜取石术术后岀血3例,肾肿瘤部分性肾切除术后岀血3例,钬激光术后2例。采用超选择方法将导管置于岀血动脉,用聚乙烯醇颗粒及弹簧圈或(和)微弹簧圈栓塞治疗。结果所有患者均一次性成功进行岀血动脉栓塞治疗,造影过程中可见动静脉瘘,对比剂外溢、滞留及假性动脉瘤形成。所有患者在栓塞治疗后岀血症状均消失,未观察到明显的肾功能损害,临床随访4～35个月未再发生岀血。结论超选择性动脉栓塞是治疗医源性肾岀血的有效、安全的方法,值得在临床推广应用。
Objective To discuss the value of super-selective arterial embolization in treating renal hemorrhage caused by iatrogenic injuries. Methods During the period from Dec. 2009 to Feb. 2012, a total of 11 patients with renal hemorrhage caused by iatrogenic injuries were admitted to authors＇ hospital. The iatrogenic injuries included nephrostomy （n = 3）, percutaneous nephrolithotomy（n = 3） partial nephrectomy for renal tumors （n = 3） and holmium laser therapy （n = 2）. By using super-selective catheterization technique, the catheter was placed into the bleeding artery, which was followed by embolization management with PVA particles, coils and/or micro-coils. Results The embolization was successfully accomplished with single manipulation in all patients. Angiography demonstrated that arteriovenous fistula, contrast extravasation and retention, the formation of pseudoaneurysm, etc. existed in diseased kidney. The hemorrhage disappeared soon after the embolization treatment and no obvious renal dysfunction was seen in all patients. During the clinical follow-up period lasting for 4 - 35 months, no recurrent hemorrhage occurred. Conclusion For the treatment of renal hemorrhage due to iatrogenic injuries, super- selective arterial embolization is safe and effective. This technique should be recommended in clinical practiee.
出处
《介入放射学杂志》
CSCD
北大核心
2012年第12期1031-1035,共5页
Journal of Interventional Radiology
关键词
肾出血
医源性
超选择动脉栓塞
renal hemorrhage
iatrogenic injury
super-selective arterial embolization
