经导管超选择性栓塞治疗急性肾动脉性血尿

Transcatheter superselective embolization treatmenting acute renal arterial original hematuria

目的 探讨经导管超选择性栓塞在急性肾动脉性血尿中的临床疗效。方法 回顾性分析55例急性肾动脉性血尿患者的临床资料,所有患者均行急诊肾动脉造影,根据造影表现不同,使用Embosphere微球和（或）弹簧圈两种栓塞剂进行超选择性介入栓塞治疗。结果 所有患者经导管超选择急诊肾动脉栓塞治疗后,53例患者栓塞1周内镜下及肉眼血尿消失;1例栓塞后并内科药物治疗2周后肉眼血尿消失;1例栓塞无效,改用外科切除。术后对患者进行随访观察6～12个月,均未发生再次出血,经导管超选择性栓塞治疗总有效率为96.36%（53/55）。结论 经导管超选择性栓塞治疗急性肾动脉性血尿疗效显著,合理地使用永久性栓塞剂既能达到彻底止血,又能最大程度保留正常的肾组织和肾功能。

Objective To discuss the clinical efficacy of transcatheter arterial embolization in the treatment of acute renal arterial original hematuria. Methods All of he 55 patients with acute renal artery original hematuria underwent renal angiography were analyzed retrospectively, referring to the difrrent angiographic manifestations, superselective renal arterial embolization by using two kinds of embolic agents such as embosphere microspheres and the ciols. Results After superselecfive renal arterial embolization, 53 cases of the gross and microscopic hematuria were disappeared within 24 hours ; 1 case after interventional embolism continued conservative treatment two week later, the gross hematuria disappeared; 1 case was failed after interventional embolism, then surgical resection was performed. After embolization, all the patients were followed up for about 6 to 12 months. The total effective rate was 96.36% （53/55）. Conclusion The therapeutic effect transcatheter arterial superselective embolization in the treatment of acute renal arterial original hematuria is significant, and appropriately using permanent embolization agents can not only effectively stop the bleeding but also preserve the normal renal tissue and renal function to the greatest possible advantage.