肾动脉栓塞3例临床分析并文献复习

Clinical analysis of 3 cases of renal artery embolism and literature review

目的探讨肾动脉栓塞引发急腹症的临床特点及诊断、治疗方法。方法总结我院收治的3例肾动脉栓塞患者临床资料。3例患者均以"突发性腹痛"为主要症状,均合并房颤或其余部位动脉血栓病史。患者均未能在第一时间做出正确诊断,2例诊为"肾绞痛",1例考虑为"主动脉夹层"。结果3例患者均通过腹部CT血管造影做出确定诊断,2例患者为局限性肾段梗死,行抗凝治疗后症状好转;1例患者为肾动脉主干梗塞,且时间超过24 h,不适宜行介入治疗,最终行肾脏切除术。结论 CT血管造影可作为肾动脉栓塞确诊的首选方法,早期诊断、早期治疗是挽救肾动脉栓塞患者肾脏功能的关键。

Objective To explore the clinical character, diagnosis and treatment of the acute abdomen caused by renal artery embolism （RAE）. Methods The clinical data of three cases of RAE in our hospital were summarised. All of them were represented ＂acute abdomen pain＂ as the main symptom and were Combined with atrial fibrillation or a history of other parts of ar- terial thrombosis. The correct diagnosis of the patients were not made in the first time. Two pa- tients were diagnosed as ＂renal colic＂, and 1 case was considerd as ＂aortic dissection＂. Re- suits Three patients were diagnosed by abdominalCT angiography, 2 patients for the limita- tions of renal infarction, symptoms improved after anticoagulant therapy; one case was embol- ism at the main trunk more than 24 h and not suitable for treatment treated with line of nephrectomy. Conclusion CT angiography is with intervention, finally considered as preferred method of diagnosis of renal artery embolization. Early diagnosis and early treatment is the key to save renal function in oatients with RAE.