肾动静脉瘘的诊断与治疗(附28例报告)

Diagnosis and treatment of renal arteriovenous fistula(Report of 28 cases)

目的：探讨肾动静脉瘘（RAVF）的诊断和治疗方法,提高RAVF的诊治水平。方法：回顾性分析28例RAVF患者的临床资料。28例患者均行肾动脉造影确诊,26例患者行选择性肾动脉栓塞,1例失败改行开放手术;3例开放手术中,2例巨大、高流量RAVF行患肾切除,1例行瘘供血动脉结扎。结果：术后28例患者均治愈;随访4～40个月,1例因血尿再发行二次栓塞,其他患者无血尿再发;所有患者肾功能正常。结论：肾动脉造影和动脉栓塞治疗是RAVF的首选诊治方法,巨大、高流量RAVF应选择外科手术治疗。

Objective：To investigate the diagnosis and treatment of renal arteriovenous fistula（RAVF）and improve the diagnostic and therapeutic level.Method：Clinical data of 28 cases with RAVF were analyzed retrospectively.The diagnoses of 28 cases were accurately made by renal arteriography.Twenty-six cases were treated with superselective renal arterial embolization.Twenty-five cases succeeded except one case converted to open surgery.Two cases of high-flow RAVF were treated with nephrectomy,and another one case was treated with ligation of the feeding artery.Result：All 28 cases were cured.Over the follow-up period of 4-40 months after operation,one case required secondary embolization for recurrent hematuria,and there was no recurrence in other cases.Renal function of all cases were found normal.Conclusion：Renal arteriography and transcatheter arterial embolization（TAE）is the first line diagnostic and treatment method for RAVF,while high-flow arteriovenous fistula should be treated with surgery.