【摘要】 目的 :评价介入栓塞治疗泌尿系统肿瘤的疗效 ,提高介入栓塞治疗泌尿系统肿瘤的水平。方法 :采用Seldinger法行经皮穿刺股动脉插管 ,以无水乙醇碘油混合剂、明胶海绵为主要栓塞物 ,用选择性或 /和超选择性插管技术栓塞治疗肾癌 37例、肾错构瘤 8例、晚期膀胱癌 2例。其中 ,术前栓塞 33例 ;治疗性栓塞 14例。结果 :33例肾癌患者栓塞术后肿瘤体积缩小、肾周水肿带明显 ,手术时出血减少 ;1例栓塞术后肿块无改变 ,1月后改行手术治疗 ;2例Ⅳ期病人行治疗性栓塞 ,术后存活 12～ 17个月 ,未再出现血尿 ;另 1例切除术后肿瘤复发患者 ,行肿块栓塞术后并发截瘫。 8例肾错构瘤行栓塞术后随访 8个月～5年余 ,肿瘤体积均有不同程度缩小 ,无血供 ,无复发。 2例晚期膀胱癌患者行栓塞治疗后出血停止 ,显著改善生存质量。结论 :介入栓塞治疗泌尿系统肿瘤是一种有效的方法 ,能提高手术成功率 ,能最大程度保留正常肾组织或显著改善生存质量。其并发症较少 ,但个别病例往往后果极其严重 ,应引起高度重视更多还原

【Abstract】 Objective:To evaluate the effect and to improve the treatment level of transcatheter arterial embolization therapy in patients with urinary tumor.Methods:Catheters were transcutaneously inserted into femur artery by Seldinger’s method and intervene embolized selected arteries by gelatin-sponge or a mixture of anhydrous alcohol and iodised oil.37 cases of renal carcinoma,8 cases of renal angiomyolipomas,2 cases of advanced bladder tumor were embolized and treated selectively or superselectively by Seldinger’s catheteration.Among all patients,33 cases were treated before surgery,and 14 cases were therapeutic embolization.Results:The tumor size decreased,the perirenal edema area became clear and bleeding in operation reduced in 33 cases of renal carcinoma.The tumor size had no change and the patient had to undergo operation in 1 case.Therapeutic embolization was given to 2 cases with stage-IV renal carcinoma.The mean survival time was 12-17 months. And hematuria hasn’t occurred;1 case with tumor relapse after nephrectomy was complicated of paraplegia after embolization treapy.8 cases with renal angiomyolipoma were followed-up 8 months to more than 5 years.Tumor size decreased,no blood supply and no one relapse.2 cases with advanced bladder tumor bleeding stopped.Survival quality of life has been significantly improved after embolization.Conclusion:Intervene embolization is an effective method for urinary tumor.It can improve the success rate of operation,maximumly reserve normal renal tissue or significantly improve survival quality.The complication of embolization is rare,but if it occurs,it is serious.Much more attention must be paid to it.更多还原