Ubara Yoshifumi, Tagami Tetsuo, Higa Yasushi, Suwabe Tatsuya, Nomura Kazufumi, Hoshino Jyunichi, Sawa Naoki, Katori Hideyuki, Takemoto Fumi, Hara Shigeko, Takaichi Kenmei
Nephrology Center, Toranomon Hospital, Kajigaya, Kawasaki.
Intern Med. 2006;45(12):769-74. doi: 10.2169/internalmedicine.45.1659. Epub 2006 Jul 18.
Conventional treatments for symptomatic enlargement of a nonfunctional hydronephrotic kidney caused by obstructive uropathy include surgical treatments.
Patients included a 67-year-old woman whose obstruction was caused by a lower urinary tract stone complicating spinal tuberculosis (patient 1); a 52-year-old man with compressive complete congenital obstruction crossing the ureteropelvic junction from an aberrant renal artery (patient 2); and a 19-year-old woman with essentially complete idiopathic congenital obstruction at the ureteropelvic junction (patient 3), who required antibiotics for pyelonephritis before embolization. The renal artery was embolized using platinum microcoils.
Although the sensation of abdominal fullness diminished within approximately two week after TAE, it took one to two years until the embolized kidney size shrank from 1377+/-634 cm3 (range, 829 to 2072) to 43+/-46 cm3 (42 to 94) by the evaluation of computed tomography. Fever after embolization persisted for 5 days in patient 1, 3 in patient 2, and 9 in patient 3. Flank pain resolved within 5 days in all. Pyelonephritis and complications of treatment have not occurred.
Embolization for this indication was safe and effective.
由梗阻性尿路病引起的无功能肾积水性肾脏症状性增大的传统治疗方法包括手术治疗。
患者包括一名67岁女性，其梗阻由下尿路结石并发脊柱结核引起（患者1）；一名52岁男性，因异常肾动脉压迫输尿管肾盂交界处导致完全性先天性梗阻（患者2）；以及一名19岁女性，在输尿管肾盂交界处存在基本完全性特发性先天性梗阻（患者3），在栓塞前因肾盂肾炎需要使用抗生素。使用铂微线圈对肾动脉进行栓塞。
虽然经动脉栓塞（TAE）后约两周内腹部胀满感有所减轻，但通过计算机断层扫描评估，栓塞后的肾脏体积从1377±634 cm³（范围829至2072）缩小至43±46 cm³（42至94）需要1至2年时间。患者1栓塞后发热持续5天，患者2持续3天，患者3持续9天。所有患者的胁腹疼痛均在5天内缓解。未发生肾盂肾炎及治疗相关并发症。
针对该适应症的栓塞治疗安全有效。
