明胶海绵在肾损伤性血尿介入治疗中应用

目的 探讨肾损伤血尿介入治疗术中明胶海绵应用的可行性与安全性。方法 应用低压流控和层流效应原理，以明胶海绵为主要栓塞剂，对10例肾损伤血尿保守治疗无效患者进行栓塞止血。结果 造影显示创伤性动脉瘤3例；血管狭窄／闭塞，并区域性肾实质显影缺失9例；动-静脉瘘3例；动脉-肾盏痿5例；肾轮廓异常3例。损伤范围累及1／2肾或以上者5例，累及1／2肾以下者5例；单纯使用明胶海绵者8例，弹簧钢圈加明胶海绵者2例；全部病例均止血成功；保肾效果满意。结论 （1）明胶海绵栓塞可用于多数肾损伤后血尿保守治疗无效者，止血效果肯定。（2）低压流控技术对提高明胶海绵栓塞的安全性十分重要。（3）对于分流量大者，需以导管限流或在钢圈应用基础上使用明胶海绵，以免顺行性误栓。

Application of gelfoam to the interventional management of traumatic renal hematuria

Objective To explore the feasibility and safety of the GF(gelfoam) applied in the interventional treatment for the traumatic renal hematuria.Methods By the principle of the low pressure fluid and the lamina flow effect,with the GF as the emboli,The 10 cases of traumatic renal hematuria were treated with interventional methods.Results The aberrant findings on renal arterogram were abserved:3 cases exogenous aneurysm;9 cases block of blood vessel with regeonsal stain defect;3 cases renal arteriovenous fistula,5 cases renal arterio-calyx fistula,and 6 cases the abnormal renal contour. The injury extended to or excess half of the kidney in 5 cases,and another 5 less than half of the kidney. All cases were treated successfully by selective renal artery embolization,with GF only in 8 cases,and coil added GF in 2 case.Conclusion (1)Gelfoam is feasible and safe in the interventional treatment for the majority of the patients suffering traumatic renal hematuria in our serial.(2)The key to enhance the feasibility and the safety of the treatment is technique of the low pressure fluid. 3.For the cases with high shunted blood flow,the GF should be applied with the coil applied ahead or restricted flow with the catheter to avoid allotopia embolization along with the flow.