经导管肾动脉栓塞的临床应用(附53例报告)

Clinical application of transcatheter renal artery embolization (report of 53 cases)

目的 :对肾肿瘤及肾出血行肾动脉栓塞术的疗效及技术进行评价。方法 :以明胶海绵、NT CRE、线段、自体凝血块及无水乙醇用于栓塞肿瘤、先天性肾动静脉瘘和肾外伤出血 ,共 5 3例。结果 :41例术前辅助治疗的肾肿瘤在肾动脉栓塞后均成功进行了肾切除术 ,手术中平均输血 40 5ml。 4例晚期肾癌姑息性栓塞治疗者术后分别存活了 3 .5、13、17和 2 5个月。 1例先天性肾动静脉瘘和 4例肾外伤出血在栓塞术后出血迅速停止 ,另 1例先天性肾动静脉瘘出血 ,行超选择肾段动脉栓塞无效后又行肾切除术。结论 :肾动脉栓塞术安全有效 ,可用于肾肿瘤的术前辅助治疗、晚期肾癌的姑息治疗及先天性肾动静脉瘘和肾外伤出血的治疗。

Objective:To evaluate the effect of renal artery embolization for the renal tumor and renal hemorrhage.Methods:In 53 patients,the embolization was achieved with the gelatin sponge,thread segment,NT CRE,self blood coagulum or absolute ethanol.Results:41 cases of renal tumor were performed the renal artery embolization as an adjuvant preoperative therapy,followed by successful resection of tumors with the average blood transfusion of 405ml during nephrectomy.The survival of 4 cases with late renal carcinoma was respectively 3.5,13,17,25 months after palliative renal artery embolization.In one case with renal arteriovenous fistula and 4 with renal trauma,bleeding had been successfully controlled by means of renal artery embolization.Only one case with renal arteriovenous fistula failed to stop bleeding after superselective renal segmental artery embotization and nephrectomy was carried out.Conclusion:Renal artery embolization may be recommended as an adjuvant preoperative therapy for renal tumor or a palliative management for late carcinoma and an effective treatment of choice for renal trauma or renal arteriovenous fistula.