| 茆丽娜,董艳彬,张忠满,刘 圣,刘边疆,王 喆.介入栓塞术在急诊难治性医源性肾出血中的临床应用价值[J].,2023,(20):3894-3898 |
| 介入栓塞术在急诊难治性医源性肾出血中的临床应用价值 |
| Clinical Application Value of Interventional Embolization in the Treatment of Acute Intractable Iatrogenic Renal Hemorrhage |
| 投稿时间：2023-03-31 修订日期：2023-04-28 |
| DOI：10.13241/j.cnki.pmb.2023.20.019 |
| 中文关键词: 介入栓塞术 急诊 难治性 医源性 有效性 安全性 |
| 英文关键词: Interventional embolization Acute Intractable Iatrogenic Efficacy Safety |
| 基金项目:国家自然科学基金项目（81770086） |
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| 中文摘要: |
| 摘要 目的：探讨介入栓塞术在急诊难治性医源性肾出血中的临床应用价值。方法：收集2012年6月至2021年6月南京医院大学第一附属医院收治的72例急诊难治性医源性肾出血的患者。所有患者在保守治疗无效的情况下，行介入下肾动脉血管造影，根据造影表现确定出血责任动脉，并行栓塞治疗，术后观察临床止血的有效性及安全性。结果：72例患者，介入血管造影呈阳性结果64例，包括血管出现单纯造影剂外溢12例，单纯假性动脉瘤19例，单纯动静脉瘘8例，9例患者合并两种造影表现，以及16例患者呈现动脉出血的一些间接征象。阳性出血患者介入栓塞技术成功率及临床止血率为100%。72例患者介入术后3 d血白细胞、血中性粒细胞比率、血红蛋白、血细胞比容及血小板较术前明显升高（均P＜0.05），血肌酐及尿素氮较介入术前轻度升高（均P＞0.05）；其中30例患者介入术后7 d再次检测血肌酐及尿素氮，较介入术前基本恢复正常（均P＞0.05）。住院期间所有患者未出现肾衰等严重的术后并发症。结论：介入栓塞术治疗急诊难治性医源性肾出血患者，具有安全、高效、并发症少等优点，临床上值得推广应用。 |
| 英文摘要: |
| ABSTRACT Objective: To evaluate the therapeutic effect of interventional embolization in the treatment of acute intractable iatrogenic renal hemorrhage. Methods: Collected 72 patients with acute intractable iatrogenic renal hemorrhage admitted to the First Affiliated Hospital of Nanjing Hospital University from June 2012 to June 2021. All patients underwent interventional renal angiography when conservative treatment was ineffective. The responsible artery for bleeding was determined according to the angiographic findings,and embolization was performed. The efficacy and safety of clinical hemostasis were observed after operation. Results: Among the 72 patients, 64 cases showed positive results in interventional angiography, including 12 cases of simple contrast agent overflow, 19 cases of simple pseudoaneurysm, 8 cases of simple arteriovenous fistula, 9 cases of combined two kinds of angiography, and 16 cases of indirect signs of arterial hemorrhage. The success rate and clinical hemostasis rate of interventional embolization in patients with positive bleeding was 100%. In 72 patients, the white blood cell count, blood neutrophil ratio, hemoglobin, hematocrit, and platelet count significantly increased 3 d after intervention compared with those before intervention(all P<0.05), while the creatinine and urea nitrogen slightly increased compared with those before intervention (all P>0.05); Creatinine and urea nitrogen were measured again in 30 patients 7 d after interventional surgery, and they basically returned to normal compared with those before interventional surgery(all P>0.05). No serious postoperative complications such as renal failure occurred in all patients during hospitalization. Conclusion: Interventional embolization for the treatment of acute intractable iatrogenic renal hemorrhage patients has the advantages of safety, efficiency, and fewer complications,which is worth promoting and applying clinically. |
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