摘要
目的探讨肾动静脉瘘致妊娠期血尿的诊断及处理方法。方法回顾2例肾动静脉瘘致妊娠期血尿的病例资料,并复习文献进行分析总结。结果 2例肾动静脉瘘致妊娠期血尿患者,年龄分别为28、30岁,均为妊娠期间出现反复间歇性全程肉眼血尿,曾行超声、CT检查,未能明确病因。分别于妊娠7周、8周就诊。均行选择性肾动脉造影或(和)超选择性肾段动脉造影确诊为肾动静脉多瘘,采用明胶海绵微粒、微弹簧圈对病变血管予以选择性栓塞。2例均采用超选择性栓塞供血动脉治疗,栓塞当天肉眼血尿即消失,术后72h内术侧腰部均出现酸痛,尚有低热、腹胀、恶心等症状。结论肾动静脉瘘有血流动力学改变并可发生破裂,妊娠期的高动力循环状态使畸形血管易于破裂,导致血尿。选择性肾动脉造影和栓塞术是肾动静脉瘘主要的诊断和治疗方法。
Objective To explore the diagnosis and treatment of hematuria in pregnancy caused by renal arteriovenous fistula. Methods Two cases of hematuria in pregnancy caused by renal arteriovenous fistula were retrospectively studied,and relevant literatures were reviewed. Results One patient was 28 years old,presenting repeatedly intermittent hematuria during 7＋ weeks＇ gestation. Another patient was 30 years old,manifesting repeatedly intermittent hematuria during 8＋ weeks＇ gesta- tion. B ultrasound and CT could not confirm the diagnosis. Selective angiography diagnosed the two cases as renal arteriovenous fistula. Then they were successfully embolized with different materials including gelfoam,coils,and so on. Conclusion Super- selective renal angiography and embolization are the most important and effective tools to diagnose and treat renal arteriove- nous fistula in pregnancy.
出处
《现代泌尿外科杂志》
CAS
2014年第2期96-98,共3页
Journal of Modern Urology
关键词
肾动静脉瘘
妊娠
血尿
血管造影
栓塞
renal arteriovenous fistula
pregnancy
hematuria
angiography
embolization
