超选择性动脉内栓塞治疗临床难治性血尿的价值

Value of superselective transarterial embolization for the refractory hematuria

目的:探讨临床难治性血尿经超选择性动脉内栓塞治疗的价值。方法:采用超选择性动脉插管技术,对31例急性血尿患者的肾动脉或膀胱动脉进行血管造影,并选用不同的材料栓塞出血病变。经一侧肾动脉栓塞27例,双侧膀胱动脉栓塞4例。结果:本组31例均完成超选择性动脉内栓塞治疗,27例(87%)于48h内血尿停止;3例(10%)48h后出血量减少,经保守治疗后止血;1例(3%)栓塞治疗失败并行患肾切除术。经随访没有发生严重并发症和肉眼血尿复发。结论:超选择性动脉内栓塞方法为临床难治性血尿提供了新的治疗途径,同时也是一种安全有效的急救手段。

Objective：To explore the value of superselective transarterial embolization in the treatment of re-fractory hematuria.Method：Thirty-one patients with acute hematuria were performed renal artery or bladder artery angiography and the superselective transarterial embolization was applied to stop bleeding using various embolic materials.The unilateral renal artery was embolized in 27cases and bilateral bladder arteries were embolized in 4cases.Result：The superselective transarterial embolization was performed in 31cases.Hematuria stopped within 48hours in 27patients（87%）;the hemorrhage decreased after 48hours in 3cases（10%）and eliminated with conservative treatment;the nephrectomy was performed in 1patient（3%）in whom the emboli-zation failed.The follow up revealed no serious complications and recurrence of gross hematuria after the embolization.Conclusion：The superselective transarterial embolization for the refractory hematuria provides a new therapeutic approach and it is a safe and effective first aid measure.