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中华介入放射学电子杂志 ›› 2014, Vol. 02 ›› Issue (01) : 15 -19. doi: 10.3877/cma j.issn.2095-5782.2014.01.005

肿瘤介入

超选择性肾动脉栓塞术治疗肾血管平滑肌脂肪瘤的疗效分析
胡绪焕1, 宋莉1, 杨敏1, 王健1, 王超1, 吕永兴1, 佟小强1,()   
  1. 1.100034 北京大学第一医院介入血管外科
  • 收稿日期:2013-07-04 出版日期:2014-03-01
  • 通信作者: 佟小强

Outcome of super-selective renal arterial embolization in treating renal angiomyolipoma

Xuhuan Hu1, Li Song1, Min Yang1, Jian Wang1, Chao Wang1, Yongxing Lv1, Xiaoqiang Tong1,()   

  1. 1.Department of Interventional Radiology and Vascular Surgery,Peking University First Hospital,Beijing 100034,China
  • Received:2013-07-04 Published:2014-03-01
  • Corresponding author: Xiaoqiang Tong
引用本文:

胡绪焕, 宋莉, 杨敏, 王健, 王超, 吕永兴, 佟小强. 超选择性肾动脉栓塞术治疗肾血管平滑肌脂肪瘤的疗效分析[J/OL]. 中华介入放射学电子杂志, 2014, 02(01): 15-19.

Xuhuan Hu, Li Song, Min Yang, Jian Wang, Chao Wang, Yongxing Lv, Xiaoqiang Tong. Outcome of super-selective renal arterial embolization in treating renal angiomyolipoma[J/OL]. Chinese Journal of Interventional Radiology(Electronic Edition), 2014, 02(01): 15-19.

目的

回顾性分析急诊情况下或预防性超选择性肾动脉栓塞术(SRAE) 治疗肾血管平滑肌脂肪瘤(AML) 的临床疗效。

方法

回顾性分析31 例进行SRAE的AML 患者, 研究栓塞前后瘤体的大小、 症状缓解、 肾功能改变等并发症情况。

结果

共治疗31 例患者的33 个病灶, 手术成功率为100%。 其中进行1 次治疗的24 例(77.42%) , 2 次5 例(16.13%) , 3 次1 例(3.23%) ,4次1例(3.23%) 。 平均随访22.3个月(3~65个月) , 瘤体最大径缩小了(2.27±0.63)cm(P﹤0.05) 。随访中, 有29 例(93.55%) 病灶缩小, 1 例患者病灶大小无明显变化, 另1 例患者术后第5 年瘤体较前轻度增大, 并因病灶出血行全肾切除术。 术前18例(18/31, 58.06%) 有临床症状者, 随访过程中4 例(4/18, 22.22%) 症状消失, 余14 例(14/18, 77.78%) 症状明显改善。 术后1 例血肌酐值轻度升高, 1例转氨酶一过性升高, 25例(80.65%) 出现栓塞后综合征。 所有患者均未出现严重并发症。

结论

SRAE在预防较大的AML出血、 治疗出血的AML方面是有效的。

Objective

To investigate the outcome of super-selective renal arterial embolization(SRAE)in treating renal angiomyolipoma(AML)in both prophylactic and emergency settings.

Methods

This retrospective study included 31 patients with renal AML who were treated by SRAE.Changes of tumor size pre-and post-treatment during follow-up period were evaluated;meanwhile complications such as changes of renal function were analyzed as well.

Results

Total 31 patients with 33 renal AML,were treated by SRAE.The success rate of operation was 100%.Twenty-four cases(77.42%)received one time treatment,5 cases(16.13%)received twice,1 case(3.23%)received three times,1 case(3.23%)received four times.The mean follow-up time was 22.3 months(ranging 3—65 months),the maximum diameter of tumor reduced(2.27±0.63)cm(P﹤0.05).During the follow-up period,the lesions reduced in 29 cases(93.55%),had no obvious change in I case,increased slightly in 1 case 5 years after operation and received total excision of kidney because of haemorrhage.Only 18 preoperative cases(18/31,58.06%)had clinical symptoms,4 cases' symptoms disappeared(4/18,22.22%),the other 14 cases'symptoms improved significantly(14/18,77.78%).Postoperatively serum creatinine of 1 case increased slightly,aminopherase of 1 case showed a transient increasing,25 cases(80.65%)showed post embolizatiou syndrome.There was no serious complication.

Conclusions

SRAE is effective and durable in preventing large AML from bleeding,treating AML presenting with bleeding.

表1 本组31 例患者SRAE 术后的并发症
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