选择性肾动脉栓塞治疗良性病变所致肾出血

目的探讨选择性肾动脉栓塞治疗良性病变所致肾出血的临床价值。方法本组10例肾出血患者，肾损伤5例（其中外伤4例，医源性损伤1例），肾血管畸形2例，肾血管平滑肌脂肪瘤1例，肾结核1例，肾囊肿1例，术前均进行了CT检查。治疗方法采用Seldinger技术穿刺行股动脉插管．进行选择性靶动脉造影及栓塞治疗。结果10例患者均通过动脉造影明确诊断，由肾动脉参与病变供血，7例可见对比剂外溢，合并假性动脉瘤4例，动静脉瘘2例。介入治疗后8例患者24h内肉眼血尿消失，2例48h后肉眼血尿消失。随防1～60个月，均无肾出血复发。结论选择性肾动脉栓塞治疗良性病变所致的肾出血，安全有效、创伤小、止血快速，并发症少，并能最大程度地保护肾功能，是可靠的治疗方法。

Superselective transcatheter embolization for treating renal hemorrhage with renal benign lesion

Objective To evaluate the clinical value of Superselective transcatheter embolization for renal hemorrhage with renal benign lesion. Methods There were ten patients with renal hemorrhage, including 5 cases of renal trauma, 2 of renal vascular malformation, 1 of renal angiomyolipema, 1 of renal tuberculosis and 1 of renal cyst. All patients were examined by computed tomography and had the symptoms of gross hematuria. They were diagnosed by selective angiography for localization, and followed by embolization with various embolie materials through Seldinger method. Results All patients were diagnosed correctly through selective angiography. The lesions were fed by renal artery and contrast medium extravasation was seen in 7 cases. There were 4 patients combined with a pseudoaneurysm. Angiography showed 2 intra-renal arteriovenous fistula.Gross hematuria ceased in 8 patients after 24 hours, 2 patients after 48 hours of interventional therapy respectively. No recurrent renal hemorrhage occurred after interventional therapy during 1-60 months follow up. Conclusions Superselective transcatheter embolization for renal hemorrhage with renal benign lesion is effective and safe, with less invasion and complications and furthermore with preservation of renal function to the utmost.