左肾静脉受压综合征的介入治疗(附6例报道)

Interventional therapy for nutcracker syndrome (report of 6 cases)

目的探讨左肾静脉受压综合征的影像学特征及介入治疗的方法和价值。方法对我院收治的6例行介入治疗的左肾静脉受压综合征患者的临床资料进行分析总结,讨论其临床特点、影像学特征及介入治疗的价值。结果6例患者影像学检查均呈典型胡桃夹综合征表现,CT血管造影多平面重建(MPR)图测得肠系膜上动脉与腹主动脉夹角为20.6°±4.04°,DSA造影术中测得受压近远侧血压差为(6.4±0.4)cmH2O;支架置入术后1年未发生支架移位、脱落及再狭窄等并发症,患者自觉症状改善明显。结论支架置入术治疗左肾静脉受压综合征安全、微创、有效。

Objective To study the imaging features of nutcracker syndrome （compression of left renal vein）, and to assess the value of the interveritional therapy for this disease. Methods The clinical data of 6 cases of nutcracker syndrome undertaken interventional therapy were collected to analyze the clinical features, imaging characteristics and interventional therapeutic value together with comprehensive literatures. Results The imaging appearance of the 6 cases showed typical left renal vein compression. The average in between angle of superior mesenteric artery（SMA）and abdominal aorta（AO）was 20.6°± 4.04° in MPR reconstructed imaging of CTA. The blood pressure gradient between proximal and distal compression sites was（6.4 ± 0.36） cmH2O. No complications of displacement and defluxion and restenosis occurred after stenting for a year. The subjective symptoms of the 6 patients improved significantly. Conclusion Endovascular stenting is a safe, mini-traumatic and effective therapy for nutcracker syndrome.