超选择性肾动脉造影及栓塞治疗的临床应用

Clinical application of super selective renal arterial angiography and embolization therapy

目的:探讨超选择性肾动脉造影诊断及栓塞治疗的应用价值。方法:12例肾动脉出血患者,采用Seldinger技术,首先行肾动脉DSA造影,明确肾动脉破裂或损伤的部位及程度,在超滑导丝的引导下用明胶海绵颗粒或金属弹簧圈进行选择插管栓塞治疗。结果:12例患者经DSA肾动脉造影后均可明确肾动脉出血部位,经选择插管明胶海绵颗粒或金属弹簧圈栓塞后均能有效止血,栓塞后造影显示出血动脉中断闭塞,对比剂外溢出血染色现象消失,术后1～3d肉眼血尿消失。结论:肾动脉栓塞术创伤小、疗效好、并发症少,能最大限度保护病肾功能,是治疗肾脏损伤出血的安全有效方法。

Objective： To evaluate the value of super selective renal artery angiography and embolization therapy. Methods： Twelve cases of renal artery hemorrhage underwent renal artery DSA imaging, using Seldinger technique, to make definite the location and degree of renal artery rupture or injury, and then re- ceived selectively intubated and embolized therapy with gelatin sponge particles or steel coil under the guidance of super smooth guide wire. Results： After renal artery angiography by DSA, the locations of renal artery hemorrhage of all patients were made definite, and successful hemostasis by the selective intubation and em- bolizition with gelatin sponge particles or steel coil achieved. After embolization, hemorrhage artery displayed interruption and block, contrast agent spillover disappeared by DSA imaging, and visual hematuria disappeared after postoperative 1-3 days. Conclusions： Renal artery embolization is an effective and safe treatment for re- nal injury hemorrhage with fewer traumas, better curative effect, less complications, and maximum protection for renal function.