介入栓塞治疗肾假性动脉瘤临床应用价值

发布时间：2018-01-17 19:17

本文关键词：介入栓塞治疗肾假性动脉瘤临床应用价值　出处：《介入放射学杂志》2015年05期 　论文类型：期刊论文

【摘要】：目的探讨介入栓塞术治疗肾假性动脉瘤(RAP)的临床应用价值及疗效。方法回顾性分析介入栓塞术治疗的11例RAP患者资料,术中分别采用普通弹簧圈、明胶海绵、聚乙烯醇(PVA)作为栓塞剂。术后随访6~24个月。结果 11例均为单发RAP,3例有出血征象。RAP位于肾上段1例,中段4例,下段5例,副肾动脉1例。单纯PVA栓塞1例,弹簧圈栓塞1例,PVA加弹簧圈栓塞1例,明胶海绵加弹簧圈栓塞8例。术后瘤体及造影剂外溢均消失,载瘤动脉呈残根样。术中患者均无明显不适,术后1周内2例出血患者血红蛋白、血细胞、红细胞压积明显升高。随访期间所有患者均无复发现象,尿常规正常。结论介入栓塞术是一种微创治疗RAP的方法 ,其安全可靠,能最大程度保护肾脏正常组织、挽救患者生命,值得推广。
[Abstract]:Objective to evaluate the clinical value and efficacy of interventional embolization in the treatment of renal pseudoaneurysm Rapp. Methods the data of 11 patients with RAP treated by interventional embolization were retrospectively analyzed. Common coils, gelatin sponges and polyvinyl alcohol (PVA) were used as embolic agents respectively. The postoperative follow-up was 624 months. Results 11 cases were single RAP. There were 3 cases of hemorrhage. Rap was located in the upper renal segment in 1 case, middle segment in 4 cases, lower segment in 5 cases, accessory renal artery in 1 case, PVA embolization in 1 case, coil embolization in 1 case, and coils embolization in 1 case. There were 8 cases of embolization with gelatin sponge and coils. The tumor and contrast media overflow disappeared and the aneurysm carrying artery showed residual root shape after operation. No obvious discomfort was found in the patients during the operation. Hemoglobin and blood cells were found in 2 patients with hemorrhage within 1 week after operation. Hematocrit was significantly increased and no recurrence was found in all patients during follow-up. Conclusion Interventional embolization is a minimally invasive method for the treatment of RAP, and it is safe and reliable. Can protect the kidney normal tissue to the greatest extent, saves the patient's life, is worth popularizing.
【作者单位】：昆明医科大学第一附属医院医学影像科;
【基金】：云南省应用基础研究面上项目(2011FZ122)
【分类号】：R692;R816.7
【正文快照】： 肾假性动脉瘤(RAP)临床上较少见,多由医源性损伤及外伤引起,一般无特殊临床表现,患者多以血尿和腰痛就诊。RAP具有症状迟发的特点,以往对其诊断和治疗均较为困难,延迟诊断可能导致失血性休克和肾切除等严重后果。如发生破裂大出血,严重者甚至危及生命。既往多用内科药物止血和

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