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目的:探讨超选择肾动脉栓塞治疗创伤性肾出血的疗效,总结诊疗经验、提高治疗水平。方法:回顾性分析2010年4月~2013年8月在我院行超选择肾动脉栓塞的36例患者的临床资料。对患者受伤原因、治疗方案、治疗结果、并发症等进行分析。结果:36例创伤性肾脏出血的患者中外伤性肾出血23例,经皮肾镜碎石术后继发性出血13例。32例(88.9%)超选择肾动脉栓塞后成功止血,2例栓塞后继续出血,再次行超选择肾动脉栓塞止血成功,2例患者因血管造影不能找到明显的出血点,行肾动脉主干栓塞后止血成功。1例患者栓塞后第2天突发肺栓塞抢救无效死亡,余35例患者均未发现栓塞相关的严重并发症。结论:超选择肾动脉栓塞是治疗创伤性肾出血的有效方法,具有创伤小,对肾功能损伤小的特点,且无严重并发症。
Objective: To investigate the curative effect of superselective renal artery embolization in the treatment of traumatic renal hemorrhage, summarize the diagnosis and treatment experience and improve the treatment level. Methods: The clinical data of 36 patients who underwent superselective renal artery embolization in our hospital from April 2010 to August 2013 were retrospectively analyzed. The causes of injury to patients, treatment options, treatment results, complications were analyzed. Results: Twenty-three cases of traumatic renal hemorrhage in 36 cases of traumatic renal hemorrhage and 13 cases of secondary hemorrhage after percutaneous nephrolithotomy. Thirty-two patients (88.9%) succeeded in stopping the bleeding after superselective renal artery embolization. Two patients continued to hemorrhage after thromboembolism, and the second transthoracic transarterial embolization was successful. Two patients could not find obvious bleeding due to angiography, Hemostatic success. One patient died of sudden pulmonary embolism on the second day after embolization, and none of the remaining 35 patients had any serious complications related to embolism. Conclusion: Superselective renal artery embolization is an effective method for the treatment of traumatic renal hemorrhage. It has the characteristics of less trauma and less damage to renal function, and no serious complications.