摘要
目的探讨超选择性肾动脉栓塞术治疗经皮肾穿刺活检术后出血的有效性和安全性。方法回顾性分析2012年9月至2019年5月22例经皮肾穿刺活检术后重度出血患者临床资料和肾动脉造影表现,评估超选择性肾动脉栓塞前后临床表现和肾功能等。结果单纯对比剂外溢13例,单纯假性动脉瘤1例,单纯动静脉瘘1例,假性动脉瘤伴对比剂外溢3例,动静脉瘘伴假性动脉瘤1例,造影结果阴性3例。19例造影发现出血患者1次栓塞后成功止血,其中1例经4次栓塞后自动出院。3例造影阴性经保守治疗后止血成功。栓塞治疗前后患者肾功能无明显变化,无严重栓塞后并发症发生。结论超选择性肾动脉栓塞治疗经皮肾穿刺术后出血安全有效。本研究将穿刺活检术后出血分为5型,其中Ⅲ、Ⅳ型保守治疗通常无效,应尽早行栓塞治疗。
Objective To investigate the clinical efficacy and safety of super-selective renal artery embolization in the treatment of hemorrhage after percutaneous renal puncture biopsy. Methods The clinical data and renal arteriographic manifestations of 22 patients with severe hemorrhage after percutaneous renal puncture biopsy,who admitted to authors’ hospital during the period from September 2012 to May 2019,were retrospectively analyzed. The preoperative and postoperative clinical materials and renal functions were evaluated.Results Angiography showed that contrast extravasation was observed in 13 patients,pseudoaneurysm in one patient,arteriovenous fistula in one patient,pseudoaneurysm together with contrast extravasation in 3 patients,arteriovenous fistula associated with pseudoaneurysm in one patient,and normal angiographic findings in 3 patients. Bleeding was detected in 19 patients,and successful hemostasis was achieved in 18 patients after one embolization procedure,and the remaining one patient was discharged on his own will after receiving four times of embolization procedure. Successful hemostasis was achieved after conservative treatment in 3 patients with negative angiographic findings. No obvious changes in renal functions after embolization were seen when compared with preoperative renal function data. No serious post-embolization complications occurred. Conclusion For the treatment of hemorrhage after percutaneous renal puncture biopsy,super-selective renal artery embolization is safe and effective. In this study,the hemorrhages after puncture biopsy are classified into Ⅰ-Ⅴ types. The conservative treatment is usually ineffective for type Ⅲand Ⅳ,for which super-selective renal artery embolization should be performed as early as possible.(J Intervent Radiol,2021,30: 79-83)
作者
张翔
刘丽
梁弦弦
卢光明
许健
ZHANG Xiang;LIU Li;LIANG Xianxian;LU Guangming;XU Jian(Medical Imaging College,Xuzhou Medical University,Xuzhou,Jiangsu Province 221004,China)
出处
《介入放射学杂志》
CSCD
北大核心
2021年第1期79-83,共5页
Journal of Interventional Radiology
关键词
经皮穿刺活检
肾动脉栓塞术
血管造影术
回顾性研究
percutaneous puncture biopsy
renal artery embolization
angiography
retrospective study
