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目的探讨介入栓塞治疗在肾部分切除术后尿漏的临床应用及疗效。方法报道2例肾部分切除术后尿漏患者的治疗,手术采用Seldinger方法穿刺右股动脉,将5 F Cobre导管置于患侧肾动脉内,造影确定残余肾动脉分支后,用PVA颗粒及微弹簧圈栓塞病变血管及分支,术后观察患者症状改善情况及相关并发症的发生。结果 2例患者均取得满意疗效,术后第1日引流液即明显减少。1例栓塞术后3 d拔除引流管,1例栓塞术后2周拔除引流管。2例术中及围术期均无明显并发症发生。随访至今,无肾积水及肾功能损害发生。结论超选择性肾动脉栓塞术以其微创、安全、有效、可以最大限度保留肾功能等优点,成为治疗肾部分切除术后尿漏的首选方法。
Objective To investigate the clinical application and efficacy of interventional embolization in the treatment of urinary leakage after partial nephrectomy. Methods Two cases of urinary leakage after partial nephrectomy were treated. The Seldinger method was used to puncture the right femoral artery. A 5 F Cobre catheter was placed in the ipsilateral renal artery. After angiography confirmed the branches of residual renal artery, The coils and branches of the coil were embolized with coils, and the symptoms of the patients were observed after operation and the related complications were observed. Results 2 patients achieved satisfactory results, drainage on the first postoperative day was significantly reduced. In one case, the drainage tube was removed 3 days after embolization, and one drainage tube was removed two weeks after the embolization. There were no significant complications in 2 cases during operation and perioperative period. Follow-up date, no hydronephrosis and renal dysfunction occurred. Conclusion Superselective renal artery embolization with its minimally invasive, safe and effective, can maximize the retention of renal function, and other advantages, as the treatment of partial nephrectomy after the preferred method of urinary leakage.