超选择性肾动脉栓塞术治疗医源性肾损伤出血

Superselective transcatheter renal artery embolization in treatment of iatrogenic renal hemorrhage

目的观察超选择性肾动脉栓塞术治疗医源性肾损伤出血的疗效及对肾功能的影响。方法收集11例医源性肾损伤出血患者,先行超选择性肾动脉造影,明确出血部位和性质,再行超选择插管,采用弹簧圈、明胶海绵进行栓塞治疗;术后随访612个月。结果对11例患者行肾动脉造影均可明确出血部位。10例一次栓塞止血成功;1例经2次栓塞后仍有持续血尿,行经尿道膀胱积血块清除术后血尿消失。随访期间无血尿发生。结论超选择肾动脉栓塞术是治疗医源性肾损伤出血的安全、有效的方法,能最大程度保护肾功能,可作为首选治疗方法。

Objective To observe the therapeutic effect of transcatheter superselective renal artery embolization for iatro-genic renal hemorrhage, as well as the impact of embolization on renal function. Methods Eleven patients with iatrogenic renal hemorrhage were enrolled. Renal arteriography was performed to observe the bleeding site and severity firstly, and then transcatheter superselective renal artery embolization with coils and gelatin sponge were performed. All patients were followed up for 6-12 months. Results In all 11 patients, bleeding arteries were found after renal angiography. Bleeding stopped in 10 patients after once embolization, but continued in one patient after twice embolization, whose hematuresis disappeared after undergoing transurethral plot clot dissection. No recurrence of hematuria was observed during the follow-ing-up period. Conclusion Transcatheter superselective renal artery embolization is secure and effective, being able to pro-tect renal function, and can be used as the preferred alternation for the treatment of iatrogenic renal hematuria.