超选择性肾动脉栓塞术治疗肾癌性血尿的效果观察

目的：评价超选择性肾动脉栓塞术治疗肾癌性血尿的临床效果。 方法：回顾性分析2015年1月至2018年1月内蒙古科技大学包头医学院第一附属医院介入治疗科收治的肾癌性血尿患者39例，男22例，女17例。患者经辅助检查均诊断为肾癌性血尿，均接受超选择性肾动脉栓塞术。术后第2、7、14、21天留取患者血液及尿液样本，行血常规及尿常规化验。 结果：39例患者均采用超液态碘油+明胶海绵微粒+明胶海绵颗粒栓塞，均一次栓塞成功，成功率达100%。其中，21例患者术后12 h肉眼血尿消失，18例术后24 h肉眼血尿消失。术后第2、7、14、21天，血红细胞数（RBC）、血红蛋白（Hb）、血细胞比容（HCT）水平均高于术前，尿RBC低于术前，差异均有统计学意义（P<0.01）。39例患者行栓塞术后均出现不同程度的栓塞综合征，临床表现为恶心、呕吐、发热及腰背胀痛等症状，经对症治疗2~5 d后消失。38例术后随访3~12个月，无一例发生异位栓塞、急性肾功能衰竭、肾坏死、肾脓肿等并发症。 结论：超选择性肾动脉栓塞术治疗肾癌可以起到终止血尿的作用，且有微创、安全可靠、并发症少等优点。

Clinical effect of superselective renal artery embolization in treatment of hematuria with renal cancer

Objective:To investigate the clinical effect of superselective renal artery embolization in treatment of hematuria with renal cancer. Methods:Retrospective analysis on 39 cases (22 males and 17 females) of hematuria with renal cancer treated in our hospital from January 2015 to January 2018 were selected. All patients were diagnosed as renal cell carcinoma hematuria by auxiliary examination and underwent superselective renal artery embolization. Blood and urine samples were collected on the 2^nd, 7^th, 14^th and 21^st postoperative day for routine blood and urine tests. Results:Thirty-nine patients were embolized with super liquid iodine oil + gelatin sponge particles. All of them were successfully embolized with a success rate of 100%. Among them, 21 patients had gross hematuria disappeared after 12 hours and 18 patients had gross hematuria eared after 24 hours after embolization. On the 2^nd, 7^th, 14^th and 21^st postoperative day, the levels of red blood cell count (RBC) , hemoglobin (Hb) and hematocrit (HCT) were higher than those before surgery, and the urine RBC was lower than that before surgery with statistically significant differences (P<0.01) . All the 39 patients had embolism syndrome after embolization. The clinical manifestations of nausea, vomiting, fever and low back pain were disappeared after symptomatic treatment for 2 to 5 days. 38 patients were followed up for 3 to 12 months. No complications such as ectopic embolization, acute renal failure, renal necrosis or renal abscess occurred. Conclusions:Superselective renal artery embolization can terminate hematuria in patients with renal cell carcinoma, and has the advantages of minimally invasive, safety and reliability, and fewer complications.