原发性急性肾静脉血栓的诊断与治疗

Diagnosis and treatment of primary acute renal vein thrombosis

目的探讨原发性肾静脉血栓（RVT）的诊断和治疗方法。方法回顾性分析2014年6月至2017年3月郑州大学第一附属医院腔内血管外科收治的9例原发性RVT患者的资料,结果9例患者中，初诊误诊1例，初诊漏诊5例；均成功行肾静脉水平以上下腔静脉滤器植入术,均溶栓并长期标准抗凝，症状缓解7例；滤器植入1个月内取出，复查血栓完全清除3例、清除率≥50％4例、清除率〈50％2例;无明显并发症。结论RVT患者初诊误诊和漏诊率高，急性期RVT行腔内治疗及规范抗凝治疗,症状缓解明显。

Objective To investigate the diagnosis and treatment of primary renal vein thrombosis （RVT）. Methods The data of 9 cases who were diagnosed with primary RVT at the department of vascular surgery in the First Affiliated Hospital of Zhengzhou University from June 2014 to March 2017 were analyzed retrospectively. Results Of 9 cases with RVT, misdiagnosis of initial diagnosis occurred in one patient, and missed initial diagnosis occurred in 5 patients. All patients received a successful implantation of inferior vena cava filter above renal veins, thrombolysis, and long-term standard anticoagulation, resulting in relief of symptoms in 7. The filter was removed one month later. 100%, ≥50%, and 〈50% of clearance of thrombus was observed in 3, 4 and 2 patients, respectively. No obvious complications occurred in any patients. Conclusion The misdiagnosis and missed diagnosis rates of initial diagnosis of RVT are high. Endovascular treatment and standard anticoagulation significantly relieve symptoms.