超选择性肾动脉栓塞术在急性肾脏出血中的应用

The application of super-selective renal arterial embolization in acute renal hemorrhage

目的：评价超选择性肾动脉栓塞术治疗急性肾脏出血的临床价值。方法：回顾性分析15例急性肾脏出血患者的临床资料，包括肾外伤5例，医源性肾损伤3例，肾动静脉畸形7例，所有病例应用弹簧圈（14例）或onyx胶（1例）对其进行超选择性栓塞治疗，随访6～18月（平均12月），观察术后疗效、并发症及复发情况。结果：所有患者均成功进行了超选择性肾动脉栓塞术，其中14例患者术后出血停止，1例患者术后当日血尿症状有所缓解，术后第一日再发血尿加重，失血性休克，急诊行肾脏切除术。所有患者未观察到明显的肾功损害，所有患者随访期间无血尿复发及其它中远期并发症。结论：超选择性肾动脉栓塞术是治疗急性肾脏出血安全、有效的方法。

Objective： To evaluate the clinical value of super-selective arterial embolization in treating acute renal hem- orrhage. Methods： All cases underwent angiographic examination and the diagnosis was confirmed. Super-selective embolization was performed in 15 patients with acute renal hemorrhage by renal artery injury（n=5）, iatrogenic renal artery injury（n=3）, and renal arterioveous malformation （n=7）. Average follow-up period was 12 months （range 6-18 months）. The therapeutic effect, complication and bleeding recurrence of super-selective embolization in the treatment of acute renal hemorrhage were evaluat-ed. Results： The super-selective arterial embolization was successfully accomplished in all the 15 patients. Immediate hemostasis was achieved in 14 patients after super-selective embolization. One patient had a kidney excision because of a re-current postoperative hemorrhage. During the clinical follow-up period, no severe complication or recurrent hemorrhage was observed. Conclusion： Super-selective renal artery embolization is a safe and effective treatment with few complications for a-cute kidney bleeding.