肾病综合征合并肾静脉血栓的介入性溶栓治疗

Interventional thrombolytic therapy of nephrotic syndrome patients with renal vein thrombosis

目的 探讨经肾动脉、肾静脉置管 ,区域性溶栓对“肾病综合征”(NS)合并肾静脉血栓的治疗作用。方法 12例经肾静脉造影确诊有肾静脉血栓形成的肾病综合征患者 ,用介入性经皮穿刺插管技术 ,将导管插入到肾动脉及肾静脉 ,固定导管 ,用微泵持续 7～ 14d区域灌注尿激酶进行溶栓治疗。结果 12例区域溶栓患者 ,溶栓后 7～ 14d颜面部水肿、双下肢水肿、腹水等显著好转 ,每日尿量增加 ,体重减轻 ,肾功能逐渐恢复 ,急性期症状改善非常明显 ,随访并继续用常规方法治疗 3～ 6个月 ,达临床治愈效果。结论 经肾动脉及肾静脉分别置管持续区域灌注尿激酶治疗NS合并肾静脉血栓见效快、疗效好、不良反应少 。

Objective To investigate the role of regional thrombolysis through renal artery and rein in patients of nephrotic syndrome with renal vein thrombosis.Methods Percutaneous transluminal Seldinger's catheterization was used in 12 nephrotic syndrome patients with renal vein thrombosis after renal phlebography. Catheter was inserted into renal artery and vein and retained 7-14 days to infuse urokinase continuously by microinfusion pump. Results In all cases showed subsidence of facial lower extremity edema as well as ascites together with decreasing body weight and reversion of noticable glomerular filtration rate for 7-14 days after the thrombolytic therapy. The routine therapy was adopted in follow up study, all cases were cured clinically.Conclusions Thrombolytic therapy through renal artery and vein for treating nephrotic syndrome with renal vein thrombosis is very practical clinically because of good and rapid efficacy as well as lesser side effects.