摘要
目的:探讨先天性肾动静脉瘘的诊断与治疗方法。方法:回顾性分析以突发性、持续性严重血尿为 主要症状的5例先天性肾动静脉瘘患者的临床资料。均行彩色多普勒超声、静脉肾盂造影(IVU)、CT及膀胱镜 检查,未能明确病因。1例行肾切除术,术后病理检查证实为肾动静脉瘘;4例行超选择性肾动脉造影确诊,同时 行栓塞治疗。结果:4例栓塞治疗患者术后肉眼血尿立即得到控制,5天后尿常规检查正常,随访3个月～8年, 均无复发,无高血压情况,双肾放射性核素扫描提示患侧肾小球滤过率轻度降低。1例肾切除患者术后血尿消 失,对侧肾功能代偿正常。结论:超选择性肾动脉造影是诊断先天性肾动静脉瘘的关键检查,同时行栓塞治疗是 最佳方法,具有创伤性小、疗效确切、并发症少的特点,可最大限度地保留患侧肾功能。
Objective:To probe into the diagnosis and treatment of congenital renal arterivenous fistula.Methods:The clinical data of 5 patients with congenital renal arterivenous fistulia were analysed retrospectively. These patients suffered from severe hematuria,but color Doppler sonography, IVU, CT and cystourethroscopy could not countribute to the diagnosis. One patient underwent nephrectomy and the diagnosis was made by clinical pathology. Four cases of congenital renal arterivenous fistula diagnosed through super-selective renal arteriography have been treated by transarteria emoblization.Results:In the 4 cases ,severe gross hematuria was controlled immediately after transarterial emoblization,the urinalysis became normal afer 5 days. These patients have been followed up for 3 to 96 months with normal blood press and well controlled hematuria. Bilateral renal emission computed tomography revealed less loss of glomerular filtration rate at the concerned side. The total renal function has become normal in all 5 cases.Conclusions:Super-selective renal arteriography is believed to be the most important diagnostic method of congenital renal arterivenous fistula. Transarterial emoblization is safe and effective for both the preservation of renal function and the treatment of congenital renal arterivenous fistula.
出处
《临床泌尿外科杂志》
2004年第12期737-739,共3页
Journal of Clinical Urology
关键词
肾血管异常
肾动静脉瘘
动脉造影
栓塞
Renal vessal abnormality
Renal arterivenous fistulia
Arteriography
Embolization
