选择性动脉栓塞治疗孤立肾错构瘤6例

Super-selective arterial embolization for the treatment of solitary renal hamartoma

目的评估平阳霉素碘油混合液联合无水乙醇超选择动脉栓塞治疗孤立肾错构瘤的有效性及安全性。方法回顾性分析2009年5月至2015年10月收治的6例孤立肾错构瘤患者。所有患者接受多次超选择动脉栓塞术,根据每次随访结果以不同栓塞材料再次作栓塞治疗。采用CT增强或MRI平扫检查随访患者病灶清除率及复发情况。结果 6例患者每次栓塞术均成功,技术成功率100%。每例患者平均手术3次,平均手术间隔时间约1年,平均随访时间2.5年。术后3、6、12个月随访提示平阳霉素碘油混合液联合PVA颗粒栓塞可缩小病灶,但不能清除病灶;平阳霉素碘油混合液联合无水乙醇栓塞可清除病灶,远期随访未见原病灶复发。结论平阳霉素碘油混合液联合无水乙醇可安全有效地栓塞肾错构瘤,可能是孤立肾错构瘤患者栓塞治疗的较好材料。

Objective To evaluate the efficacy and safety of super-selective arterial embolization （SAE） by using the mixed solution of Pingyangmycin and iodine oil combined with the absolute alcohol in treating solitary renal hamartoma. Methods The clinical data of 6 patients with solitary renal hamartoma, who were admitted to authors＇ hospital during the period from May 2009 to October 2015, were retrospectively analyzed. Each patient received several times of SAE, and based on the follow-up results different embolization materials were employed for the next embolization procedure. Follow-up enhanced CT or plain MRI was employed to check the elimination rate and the recurrence of the tumor. Results All SAE procedures were successfully accomplished in all 6 patients, the technical success rate was 100%. Each patient received 3 times of SAE on average. The mean interval time for operation was about one year, and the mean follow-up time was 2.5 years. Follow-up examination at 3, 6 and 12 months after SAE showed that the mixed solution of Pingyangmycin and iodine oil plus polyvinyl alcohol （PVA） particles could only reduce the tumor size, but could not eliminate the lesion, while the ）nixed solution of Pingyangmycin and iodine oil plus absolute alcohol could eliminate the lesion, and long-term follow-up examination showed that no recurrence of the primary lesion was observed. Conclusion The mixed solution of Pingyangmyein and iodine oil plus the absolute alcohol can safely and effectively obstruct the renal hamartoma, it may be a good embolism material for solitary renal hamartoma.