动脉栓塞治疗肾血管平滑肌脂肪瘤破裂出血

目的评价选择性动脉栓塞治疗肾血管平滑肌脂肪瘤破裂出血的安全性和有效性。方法3例经B超、CT确诊的肾血管平滑肌脂肪瘤患者,左肾1例,右肾1例,双肾1例,突然出现腰腹痛、神志淡漠,血压下降等出血症状,急诊行选择性肾动脉造影和栓塞治疗,栓塞剂用无水酒精和弹簧圈。结果3例患者造影发现:肿瘤区血管紊乱并有动脉瘤形成,栓塞后造影显示:肿瘤血管血供减少,肿瘤内载有动脉瘤血供闭塞。无严重并发症出现。术后随访患者血压上升,临床症状改善。结论选择性动脉栓塞治疗肾血管平滑肌脂肪瘤破裂出血,能有效地控制出血并能最大限度保护正常肾组织,应作为急诊出血首选治疗方法。

Renal angiomyolipoma with rupture: treatment with arterial embolization

Objective To evaluate the efficacy and safety of selective arterial embolization in renal angiomyolipoma(RAML) with rupture.Methods Three patients with RAML were diagnosed by ultrasonography(US) and computed tomography(CT).One patient had AML in the left kidney and another in the right and one patient in both kidneys.One patient had tuberous sclerosis. Three patients had symptoms of acute hemorrhage and sudden pain in abdominal or back.Selective renal arterial embolization has been used to control bleeding.The embolic materials were used as alcohon and coils.Results Tumor size was measured on CT images.The size of the intratumoral aneurysm was measured on angiographic images.The angiography showed devascularization of the tumor and aneuysm after embolization in three patients.No serious complications occurred.The clinical symptoms of bleeding and pain were relieved in different degrees.Conclusion Selective arterial embolization is an effective treatment of RAML,especially in the condition of acutely hemorrhaging and it spares normal renal parenchyma.It regards as the first management of RAML with bleeding.