超选择性肾动脉栓塞治疗肾损伤出血临床应用

Superselective renal artery embolization for the treatment of traumatic renal hemorrhage

目的研究创伤性肾出血在保守治疗无效情况下进行动脉栓塞的造影表现及栓塞方法。方法采用超选择性肾动脉栓塞术治疗25例肾损伤患者,所有病人在栓塞前都进行肾动脉造影证实诊断。栓塞材料用明胶海绵加金属钢圈。结果24例病人经栓塞后,临床症状很快得到缓解,1个月后进行静脉尿路造影检查,伤侧肾功能恢复。1例栓塞后仍持续性血尿行肾切除。结论对创伤性肾出血病人,采用肾功脉栓塞具有止血效果好、能最大限度保护肾功能、减少并发症,是一种治疗肾损伤的安全有效方法。

Objective To stuby the angiographic manifestations and arterial embolization for traumatic renal hemorrhage when conservative treatment had failed.Methods 25 patients with renal traumatic injures were treated by superselective renal embolization.All patients underwent angiographic examinations and the definite diagnosis before the embolization.Embolization materials used in the study were gelfoam and steel coils.Results Clinical symptoms in all cases subsided quickly after embolization except one was cured with renal excision for the severe hematuria.One month later,intravenous urographic examination revealed recovered function of the injured kidney.Conclusion Superselective renal arterial embolization in treating traumatic renal hemorrhage has very obvious hemostatic efficacy,less complications and therefore it is a safe and effective method for the treatment of traumatic renal injuries.