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目的 探讨血管性肾脏介入技术及其临床应用价值。方法 采用经皮股动脉穿刺、选择性肾动脉造影及化疗、栓塞术诊断和治疗了62例(共69次介入操作)肾脏疾患者。结果 69例次介入操作均一次成功,无严重并发症;其中单纯诊断性造影占31.9％(22/69),治疗性造影占68.1％(47/69)。肾动脉造影不仅准确显示了肾血管解剖、肾灌注及血流动力学变化,还可动态显示尿路的解剖形态与功能;其诊断的敏感性为100％,准确性结合CT/MRI为98.4％(61/62)。介入治疗后患者症状明显好转,肿瘤有不同程度的退缩,11例肾癌栓塞后再行病肾切除者术中出血较少、病理显示肿瘤血管血栓形成或栓塞。结论 肾脏血管性介入诊疗技术安全、有效,因其微侵袭特性而主张多应用于介入治疗。
Objective To investigate the technique of vascular renal intervention and its clinical value. Methods Percutaneous femoral artery puncture, selective renal artery angiography and chemotherapy, embolization were used to diagnose and treat 62 cases (69 interventional procedures) of renal diseases. Results All the 69 interventions were successful without serious complications. Among them, 31.9% (22/69) had simple diagnostic angiography and 68.1% (47/69) had therapeutic angiography. Renal artery angiography not only accurately shows the renal vascular anatomy, renal perfusion and hemodynamic changes, but also dynamically display the anatomical morphology and function of the urinary tract; its diagnostic sensitivity was 100%, accuracy with CT / MRI was 98.4% (61/62). After the interventional treatment, the symptoms of the patients improved obviously, and the tumors were retreated in varying degrees. There were less bleeding during operation in 11 cases of renal cell carcinoma after embolization of renal cell carcinoma, and the pathology showed tumor blood vessel thrombosis or embolism. Conclusion The diagnosis and treatment of renal vascular interventional therapy is safe and effective. It is advocated that it should be used for interventional therapy because of its micro-invasion characteristics.