超选择肾动脉栓塞术在外伤性肾损伤治疗中的应用

Treatment of traumatic renal injury with superselective renal artery embolization

目的探讨超选择肾动脉栓塞术在外伤性肾损伤治疗中的优点。方法对18例多发伤中肾损伤出血患者,经肾动脉造影明确动脉损伤的部位及程度后,采用改良Seldinger穿刺技术,用明胶海绵或金属弹簧圈及明胶海绵进行栓塞。结果 17例患者在行超选择性动脉栓塞治疗后,血压稳定,肾功能正常,血尿逐渐消失。仅1例患者术后存在血尿,给予第2次栓塞治疗,血尿消失。所有患者术后3个月及半年随访,未发现血尿,肾功能无异常,影像学检查显示术侧肾及周围未发现肾周脓肿及囊肿。结论超选择性肾动脉栓塞术具有侵袭小、止血效果好、能最大限度保护肾功能、并发症少等优点,是一种治疗肾损伤的安全有效的方法。

Objective To assess the advantages of the treatment of traumatic renal injury with superselective renal artery embolization.Methods 18 cases with renal injury hemorrhage in multiple injury,using renal arteriography to determine the injuried part and degree,were treated with superselective embolization of renal artery using gelfoam or gelfoam combined with coil through modified Seldinger technology.Results After embolization of renal artery,17 cases had a stable blood pressure,renal function was normal,hematuria gradually disappeared,only 1 case existed hematuria,after the second embolization,hematuria disappeared.In 3 months and six months follow-up study,all cases had a normal renal function,no haematuria was founded,no perinephric abscess and cyst were detected on the surgery kidney and its surrounding through imaging examination.Conclusion Superselective renal artery embolization,has advantages of less aggression,good hemostatic efficacy,and less complications,it is a safe and effective method for the treatment of renal injuries.