白芨选择性肾动脉栓塞治疗肾错构瘤疗效观察

Observations on effeicacy of bletilla satriata as an embolizing agent for selective embolization of renal artery to treat AMLS

目的 :观察以白芨为栓塞材料对肾错构瘤行超选择性栓塞的治疗效果。方法 :对 5例经 CT、B超确诊为肾错构瘤的患者行白芨粘胶剂栓塞 ,栓塞后每 3个月作 B超复查 ,每半年行 CT复查 ,比较肿瘤的变化以及症状改善的情况。随访 2～ 4年。结果 :临床症状术后均有不同程度减轻或消失 ,肿瘤缩小的百分率为 5 2 %～ 75 % ,平均为 6 4% ;肿瘤有液化但呈分隔片状 ,未融合成巨大囊肿 ,所有患者未出现严重并发症。结论 :对不能采用剜除术或肾部分切除术、特别是对侧肾亦有肿瘤和病变的肾错构瘤患者 ,应首先考虑作超选择性栓塞治疗。白芨作为栓塞材料引起的并发症少 ,且兼有抗感染、抗肿瘤和促进凝血的功能 。

Purpose:To evaluate the efficacy of seletive renal artery embolization in symptomatic renal angiomyolipoma (AML) with chinese medicine bletilla striata as a vascular embolization agent.Methods:5 patients with symptomatic AMLS,1 male,4 female with a mean age of 55,underwent selective renal arterial embolizations.Before embolization the diagnosis were confirmed by US and CT.After embolization, follow up was made in all patients for 2~4 years.Results:The clinical symptoms in all 5 patients disappeared or relieved in different degrees.The shrink of tumor mass reached 52% to 75%, with a mean percentage of 64% at 24~48 months. CT follow up showed liquefactive necrosis in all 5 embolized tumors ,which was distributed as separate smaller areas, but no large cystic lesion found. No severe late complications found. Conclusions:Selective renal artery embolization should be considered as a primary theraputic modality for multiple angiomyolipomas or a very large one in a kidney, which can′t be removed by partial nephrectomy or enucleation. Bletilla Striata,as an embolization agent should be studied furtherly and applied widely.