摘要
目的评价电解可脱性微弹簧圈(GDC)栓塞在医源性肾出血中的应用价值。方法 30例保守治疗无效医源性肾出血患者,按介入时间顺序随机抽取采用GDC、明胶海绵、微弹簧圈为栓塞材料进行超选择性肾动脉栓塞治疗,每种方法 10例,观察其治疗效果,肾功能损伤情况,肾梗死范围。统计数据采用SPSS软件进行处理,均数间的比较采用t检验,组间差异比较采用方差分析。结果所有治疗患者均一次栓塞获得成功,术后血尿完全消失,随访未出现再发出血,肾功能均未出现异常。术后梗死范围比较,明胶海绵组、微弹簧圈组、GDC组的梗死范围分别为(57.50±7.071)%、(18.36±3.776)%、(4.09±1.758)%。明胶海绵组与微弹簧圈组比较有显著统计学差异(P=0.000),明胶海绵组与GDC组比较有显著差异(P=0.000),微弹簧圈组与GDC组比较有显著差异(P=0.000),且GDC栓塞患者肾梗死范围最小。结论超选择性肾动脉栓塞为保守治疗无效的医源性肾出血提供了一种安全且有效的治疗方法,GDC的使用可更好地防止栓塞后正常肾组织缺失。
Objective To evaluate the application value of guglielmi detachable coils （GDC） in embolization of iatro- genic renal hemorrhage. Methods 30 iatrogenic renal hemorrhage patients with failed conservative treatment were ran- domly treated by superselective transcatheter arterial embolization （TAE） with GDC, gelatin sponge, and microcoil emboli- zation, respectively. The efficacy of treatment, damage to renal function, and renal infarction size were observed. Statisti- cal data were analyzed by SPSS, the mean was compared by t test and the differences between two groups were compared by analysis of variance （ANOVA）. Results The embolizations were successful in all patients at the first attempt. Hematuri- a was disappeared completely after the surgery ; no recurrence of hemorrhage and no abnormal renal function were observed during the follow up. Compared the ranges of infarction after the surgery, the ranges of infarction of gelatin sponge, micro- coil embolization and GDC group were （57.50 ＋ 7. 071 ） %, （ 18.36 ~ 3. 776） %, （4.09 ~ 1. 758 ） %, respectively. There was significant difference between gelatin sponge and microcoil embolization（ P = 0.000）, gelatin sponge and GDC group （ P = 0.000）, microcoil embolization and GDC group （ P = 0. 000）, and postoperative angiography demonstrated that pa- tients treated with GDC embolization exhibited minimum renal infarct. Conclusion Superselective TAE provides a safe and effective therapy to patients with iatrogenic renal hemorrhage, the application of GDC can better prevent the loss of nor- mal renal tissue after embolization.
出处
《临床放射学杂志》
CSCD
北大核心
2013年第3期410-413,共4页
Journal of Clinical Radiology
关键词
医源性肾出血
栓塞
治疗性
电解可脱性微弹簧圈
Iatrogenic renal hemorrhage Embolization Therapeutic Guglielmi detachable coils
