【摘要】 目的 探讨肾包膜动脉栓塞(RCAE)联合超选择性肾动脉栓塞术(SRAE)治疗损伤性肾出血(TRH)的安全性及有效性。方法 回顾性选取50例TRH患者。观察组25例使用RCAE联合SRAE治疗;对照组25例使用SRAE治疗。随访3个月,记录患者围术期相关指标症状改善情况及术后3个月相关并发症发生情况。结果 2组患者均成功行介入手术控制肾出血。2组患者在血管损伤的位置、造影表现、肾动脉栓塞术(RAE)使用栓塞材料等资料比较,差异无统计学意义(P>0.05)。2组间术前血红蛋白(Hb)、肾区疼痛视觉模拟量表(VAS)评分、血肌酐(Scr)、收缩压及术后7 d Scr、术后1个月收缩压分别比较,差异无统计学意义(P>0.05),而2组间术后24 h Hb、肾区疼痛VAS评分比较,差异有统计学意义(P<0.05)。观察组术后满意度率高于对照组,而术后住院时间短于对照组,差异有统计学意义(P<0.05)。结论 2组治疗TRH均可提高术后24 h Hb、降低术后24 h肾区疼痛VAS评分,而观察组较对照组明显提高术后24 h Hb及患者满意度率、降低术后24 h肾区疼痛VAS评分、减少术后住院时间。RCAE联合SRAE治疗TRH是一种安全、有效、微创的止血方法,值得推广。更多还原

【Abstract】 Objective To explore the safety and effectiveness of renal capsular artery embolization(RCAE) combined with superselective renal artery embolization(SRAE) in the treatment of traumatic renal hemorrhage(TRH).Methods A total of 50 patients with TRH were retrospectively selected.Among them,25 patients in the observation group were treated with RCAE combined with SRAE;25 patients in the control group were treated with SRAE.The patients were followed up for 3 months,in which the improvement of related indicators and symptoms during the perioperative period and the occurrence of related complications within 3 months after surgery were recorded.Results Both groups of patients successfully underwent interventional surgery to control renal bleeding.There were no statistically significant differences in the location of vascular injury,angiographic manifestations,and embolization materials used for renal artery embolization(RAE) between the two groups(P>0.05).There were no statistically significant differences in preoperative hemoglobin(Hb),visual analogue scale(VAS) score of renal pain,serum creatinine(Scr),systolic blood pressure,postoperative7 d Scr and postoperative 1 month systolic blood pressure between the two groups(P>0.05).When comparing postoperative 24 h Hb and VAS score of renal pain between the two groups,the differences were statistically significant(P<0.05).The postoperative satisfaction rate of the observation group was higher than that of the control group,and the postoperative hospitalization time was shorter than that of the control group,with statistical significance(P<0.05).Conclusion The treatment of TRH in both groups can increase Hb 24 h after surgery and reduce VAS score of renal pain 24 h after surgery.Compared with the control group,the observation group significantly can improve postoperative 24 h Hb and patient satisfaction rate,reduce postoperative 24 h VAS score of renal pain,and reduce postoperative hospitalization time.RCAE combined with SRAE is a safe,effective,and minimally invasive hemostasis method for the treatment of TRH and is worthy of promotion.更多还原