超选择肾动脉栓塞对医源性肾出血患者治疗的有效性及安全性评估

Efficacy and Safety of Super-selective Renal Artery Embolization of Iatrogenic Kidney Hemorrhage

目的探讨超选择介入栓塞对医源性肾出血患者治疗的有效性及安全性。资料与方法 32例经保守治疗无效的医源性肾出血患者行肾动脉造影检查,明确出血部位后行超选择肾动脉栓塞治疗(SRAE)。以栓塞后即刻造影显示出血部位无对比剂外溢征象为技术成功标准、术后3d内血尿完全消失为临床成功标准,评价SRAE的成功率;评估栓塞手术前后肾功能及血压的变化。结果 32例患者肾动脉栓塞技术成功率为100.0%(32/32),临床成功率为93.7%(30/32);SRAE术后平均随访9.5个月(5d～1年),3例出现肾功能下降,1例术后肾功能较术前好转;1例术后血压升高,1例术后新发高血压。结论超选择介入栓塞治疗医源性肾出血有较高的技术成功率和临床有效率,并且对肾功能及血压的影响较小,是一种安全有效的治疗方法。

Purpose To evaluate the efficacy and safety of super-selective renal artery embolization in patients with iatrogenic kidney hemorrhage. Materials and Methods Thirty-two patients with iatrogenic kidney hemorrhage underwent renal angiography after ineffective conservative treatment. After identifying the location of bleeding, super- selective renal artery embolization （SRAE） was performed. No contrast extravasation immediately alter embolization indicated technical success, whereas disappearance of hematuria indicated clinical success. Renal lhnction and blood pressure changes belbre and alter SRAE were evaluated. Results The technical success rate of SRAE in 32 patients was 100.0% （32/32）, and clinical success rate was 93.7% （30/32）. The average follow up was 9.5 months （5 d-1 year） with 3 cases showing decreased renal function, I case showing increased renal function, 1 case demonstrating increased blood presstlre, and 1 case presenting with newly developed hypertension. Conclusion SRAE is highly successful both technically and clinically with limited effect on renal function and blood pressure. It is a sale and effective treatment in patients with iatrogenic kidney hemorrhage.