超选择性肾动脉栓塞术在肾损伤治疗中的应用

Applicafion of arterial embolization therapy in the treatment of traumatic renal injury(Report of 38 cases)

目的研究肾损伤出血进行超选择性肾动脉栓塞的治疗方法及效果。方法本组15～ 6 0岁病人38例,均有明确外伤史;主要临床症状：腹痛,血尿,腰部肿块,血压下降,心率加快：合并失血性休克1 0例,3 8例病人在栓塞前都进行了肾动脉造影证实诊断,栓塞材料以自身血凝块为主,加用明胶海绵颗粒。结果3 8例病人经过栓塞后临床症状很快得到缓解,血压1～ 2h内恢复正常,血尿1～ 3h转清,术后1～ 3个月复查CT及静脉尿路造影,除1例尿性囊肿外,其余均正常。结论超选择性肾动脉栓塞治疗肾损伤出血止血效果良好,能达到止血作用又有效保护肾功能。

Objective To study the angiographic manifestations and arterial embolization for traumatic renal in jury when conservative treatment had failed.Methods 38 cases,ranging in age from 16～60 years had history of injury.The main symptoms included severe abdominal pain,hematuria or coffe-colred urine,rapid heart rat,ehypertention.10 suffered from hemorrhage shock.All cases underwent angiographic exam and the diagnosis was confirmed.Embolization materials were mainly self-blood clot and gelfoam.Results Symptoms in all cases subsided quickly after embolinzation.Blood pressure recovered to normal within 1～2houres.Hematuresis and abdominal pain disappeared or reduced in 1～3 houres.Conclusion Renal arterial embolization in treating turaumatic turaumatic renal hemorrhage can control the bleeding while preserving the injured kidneys.