超选择性肾动脉栓塞术治疗急性肾脏出血

目的:评价超选择性肾动脉栓塞术治疗急性肾脏出血的临床疗效。方法:回顾性分析14例急性肾脏出血患者的临床资料,包括肾动脉创伤3例,多囊肾3例,肾动静脉畸形8例,所有病例采用COOK弹簧圈行超选择性肾动脉栓塞术进行止血治疗。随访9～14个月(平均12.5个月),观察术后疗效、并发症及复发情况。结果:所有患者均成功进行了超选择性肾动脉栓塞术,止血成功率100%,5例患者术后出现肾区疼痛或原有疼痛程度加重,3例出现术后发热,上述症状经对症治疗均于1周内消失,无严重并发症发生。所有患者随访期间无血尿复发及其它中远期并发症。结论:超选择性肾动脉栓塞术是治疗急性肾脏出血安全、有效的方法,可以达到即刻止血和保存肾脏的目的。

Superselective coil embolization in acute renal hemorrhage

Objective：To evaluate the safety and efficiency of superselective microcoil （Cook Medical,Bloomington, IN） embolization in the treatment of acute renal hemorrhage. Methods： Superselective microcoil embolization was performed in 14 patients with acute renal hemorrhage caused by renal artery injury （n：3）, congenital polycystic kidney disease （n= 3）, and renal arteriovenous malformation （n= 8）. Embolization was performed as peripherally as possible with use of coaxial catheter systems. Median follow--up period was 12.5 months （range 9~14 months）. The effect, complication and bleeding recurrence of superselective microcoil embolization in the treatment of acute renal hemorrhage were evaluated. Results： Im- mediate hemostasis was achieved in all the 14 patients after superselective microcoil embolization. 5 patients developed flank pain and 3 patients developed fever. The patients recovered from postembolization symptoms within a week after treatment. No severe complication or bleeding recurrence was observed after intervention. Conclusion： Superselective renal artery embo- lization is a safe and effective treatment with few complications for acute kidney bleeding.