栓塞治疗先天性肾动静脉畸形(附五例报告)

Intervening embolization for congenital renal arteriovenous malformation

目的 总结经导管血管内栓塞治疗先天性肾动静脉畸形 (RAVM )的疗效。 方法 回顾性分析以间歇性全程肉眼血尿为症状的 5例RAVM患者的临床资料。 5例均经数字血管减影术(DSA)检查确诊为RAVM ,采用不同的栓塞剂 (无水酒精、碘油、明胶海绵颗粒、弹簧圈 )行经导管血管内栓塞治疗。 结果 5例患者经超选择性肾动脉栓塞后肉眼血尿立即得到控制 ,2 4h后尿液逐渐转清 ,7d后尿常规检查正常 ,随访 6～ 12个月 ,平均 10个月 ,症状无复发 ,无高血压和肾功能损害 ,双肾放射性核素 (ECT)扫描提示患侧仅部分肾皮质功能受损。 结论 肾动脉造影是诊断RAVM的最可靠方法。经导管血管内栓塞具有创伤小、并发症少、康复快、住院时间短等优点 ,可避免肾切除以及相关的手术并发症 。

ObjectiveTo evaluate transcatheter arter ia l embolization(TAE) on congenital renal arteriovenous malformation(RAVM).MethodsFive cases of RAVM,diagnosed on digital substraction a ngiography have been treated between March 1995 and May 2002 by transarterial em bolization (TAE) with different embolic agents (ethanol,iodised oil,gelform part icles or metalic coils).The efficacy was evaluated.ResultsIn all the 5 cases,gross hematuria was controlled immediately after TAE,th e urine turned clear in 24 h and urinalysis became normal in 7 days.The patients have been followed up for 6～12 months with an average of 10 months with hematu r ia well controlled in all.There has been no hypertension or apparent renal funct ion damage.Bilateral renal emission computed tomography (ECT) reveated only some local loss of the renal cortical function on the concerned side.ConclusionsAt present renal arteriography is still the most reliable method in the diagnosis of RAVM.TAE has the benefits of less inva sive, a low incidence of complications, early resumption of normal activities an d shorter hospital stay,and can avoid renal resection and correlative surgical c omplications.The renal function could be well protected from harm.