超选择肾动脉栓塞治疗外伤性肾出血:38例报告

目的探讨介入超选择插管肾动脉栓塞治疗肾损伤出血的临床应用价值。方法38例肾脏损伤出血患者,采用Seldinger技术,首先行肾动脉DSA造影,明确肾动脉破裂或损伤的部位及程度,在超滑导丝的引导下用明胶海绵颗粒或金属弹簧圈进行超选择插管栓塞治疗。结果38例患者经DSA肾动脉造影后均可明确肾动脉出血部位,经超选择插管明胶海绵颗粒或金属弹簧圈栓塞后均能有效止血,栓塞后造影显示出血动脉中断闭塞,对比剂外溢出血染色现象消失,术后1～3d肉眼血尿消失。结论介入超选择插管肾动脉栓塞治疗肾损伤出血创伤小、疗效好、并发症少、能最大限度的保护肾功能,具有独特的优越性,对于治疗肾损伤出血是一种简捷有效的方法,值得推广使用。

Superselective renal artery embolization for traumatic renal hemorrhage: report of 38 cases

Objective To evaluate the clinical application of superselective renal artery embolization for the treatment of traumatic renal hemorrhage. Methods Thirty eight patients with traumatic renal hemorrhage were first demonstrated by renal arterigraphy under seldinger technique to ensure the rupture site and degree of renal artery and then followed by percutaneous cathetherized superselective renal arterial embolization through guidance of super slippery guide wire with gelfoam particles or steel coil. Results All 38 patients revealed occlusive abruption of bleeding arteries and disappearance of vextravasation staining after the superselective catheterized renal arterial embolization with gelfoam particles and steel spring coil under DSA. Clinically, all patients urine turned clear without macroscopic hematuria during 1 - 3 days after the procedure. Conclusions Superseclective renal arterial embolization is less aggressive and simultaneously with less complications, good hemostatic efficacy, maximal preservation of renal tissue and function for renal traumatic hemorrhage, which is worthy to be recommended.