【摘要】 目的回顾性评价平阳霉素碘油乳剂联合聚乙烯醇(PVA)颗粒超选择栓塞治疗肾血管平滑肌脂肪瘤(RAML)的长期结果、并发症。方法65例患者共栓塞77个肾脏的86枚肿瘤,栓塞剂为平阳霉素碘化油乳剂及PVA颗粒。随访1年时,在CT图像上测量肿瘤大小并与栓塞前比较,计算肿瘤缩小率,通过观察栓塞治疗后患者症状及并发症、肿瘤大小的变化评价栓塞效果。结果65例患者栓塞前肿瘤直径为(8.2±3.3)cm,随访1年时为(3.9±2.7)cm,平均缩小(4.3±1.6)cm,缩小率为30%～78%(中位数54.4%),两者差异有统计学意义(P<0.05)。38例(58.5%)术后1～3 d出现栓塞后症候群;5例(7.7%)术后3～6个月随访时肿瘤复发,进行第2次栓塞。随访期内均无血尿、再次出血或与RAML及栓塞有关的其他严重症状和肾功能衰竭。结论平阳霉素碘油乳剂联合PVA颗粒栓塞治疗RAML,安全可靠。更多还原

【Abstract】 Objective To evaluated long term outcomes and complications in renal angiomyolipomas (RAML) after transcatheter arterial embolization(TAE).Methods Sixty-five patients underwent superselective embolization for 77 kidneys and 86 RAMLs.The angiomyolipomas were embolised with a mixture of lipiodol and pingyangmycin and polyvinyl alcohol particles(PVA),coils were used in any case with complication of aneurysms.At 1 year follow up,the complications after TAE were reviewed,and the size of the tumor and recurrence of the angiogenic component were measured with CT scan.Results The mean tumor size was(8.2±3.3) cm,the size decreased to (3.9±2.7) cm at the time point of 1 year after TAE.The mean tumor size reduction was(4.3±1.6) cm at long term follow up,with the tumor size reduction rate was 30%～78%(median 54.4%).Tumor sizes was decreased significantly between pre TAE and long term follow up(P<0.05).Thirty-eight(58.5%) patients had post embolization syndrome following TAE.Five patients(7.7%) had tumor recurrency at 3～6 months follow up and underwent second embolization.There were no procedure related complications,no hemorrhage or renal failure was identified during the follow up period.Conclusion Transarterial embolisation with a mixture of lipiodol and pingyangmycin and PVA was an effective and safety method to treat RAML.更多还原