先天性肾动静脉畸形的栓塞治疗

目的评价经导管动脉栓塞治疗先天性肾动静脉畸形的价值。方法回顾性分析7例以肉眼血尿为主要症状的先天性肾动静脉畸形,选择性肾动脉造影确诊为肾动静脉畸形后,超选择性病变动脉插管,用明胶海绵、无水乙醇、弹簧钢圈等对病变血管进行栓塞治疗。结果所有7例先天性肾动静脉畸形都成功栓塞,栓塞24h内7例肉眼血尿消失,术后1周内可有栓塞侧腰部酸痛、低热、腹胀、恶心、呕吐等症状,但无严重并发症。随访36～98个月无血尿复发,肾功能正常。结论经导管肾动脉造影能明确诊断,动脉栓塞安全有效,对先天性肾动静脉畸形的治疗有重要意义。

Transcatheter arterial embolization for congenital renal arteriovenous malformation

Objective To evaluate the effectiveness of transcatheter arterial embolization for congenital renal arteriovenous malformation.Methods Seven cases of congenital renal arteriovenous malformation causing gross hematuria were retrospectively studied.All of 7 cases were demonstrated by means of angiography and then the catheter was placed superselectively into the involved arterial end of the malformation undertaking embolization with gelfoam,dehydrated ethanol,coils,etc.Results All the malformations of the 7 cases were successfully embolized with stoppage of gross hematuria within 24 hours.No serious complications occurred except lumbago,fever,gastrointestinal reaction for one week.There was no recurrence of haematuria and the renal function was also normal in all cases during the follow-up for 36 to 98 months.Conclusions Transcatheter renal arterial angiography and embolization are the important and effective management for the diagnosis and treatment of congenital renal arteriovenous malformation.