Elalouf V, Vandwalle J, Viart L, Petit J, Saint F
Service d'urologie - transplantation, CHU d'Amiens, université Picardie Jules-Verne, avenue R-Laennec, Salouel, 80054 Amiens cedex 1, France.
Prog Urol. 2011 Mar;21(3):184-90. doi: 10.1016/j.purol.2010.08.052. Epub 2010 Oct 14.
Through a retrospective cohort, to analyse causative factors of acute renal infarction and specific therapeutic. Recall the need to carry a computerised tomoraphy (CT) in any flank pain suggestive of renal colic can hide a renal infarct.
Over a period of 24 months (2008-2009), we have compiled six patients admitted for acute lumbar pain reported in renal colic and showing a renal infarction. We report the risk factors for cardiovascular disease, the clinical presentation, and the interest of heparin therapy started early in the recovery of renal function. We emphasise the need for abdominal-pelvic CT in emergency before a renal colic pain associated with injection of contrast medium if no stone obstacle is identified.
Five patients had risk factors for cardiovascular disease including one personal history of deep vein thrombosis and pulmonary embolism and two, a family history of myocardial infarction. Five patients were treated early with LMWH, and for one the herapin was started at 72 hours of onset of symptoms. In all cases, no effect on renal function was noted.
Renal infarction is a rare but probably underestimated, occurring on land known cardiovascular often. The abdominopelvic CT without injection is increasingly practiced in front of abdominal pain syndromes, it seems imperative to complete the review by the injection of contrast material if stone obstruction is unconfirmed. Early management by herapin appears to improve the complete recovery of renal function.
通过一项回顾性队列研究，分析急性肾梗死的病因及特异性治疗方法。提醒注意，对于任何提示肾绞痛的侧腹痛，进行计算机断层扫描（CT）检查的必要性，因为肾绞痛可能掩盖肾梗死。
在24个月（2008 - 2009年）期间，我们收集了6例因肾绞痛就诊且被报告为急性腰痛并显示有肾梗死的患者。我们报告了心血管疾病的危险因素、临床表现以及早期开始肝素治疗对肾功能恢复的益处。我们强调，如果未发现结石梗阻，在与注射造影剂相关的肾绞痛疼痛出现之前，急诊时进行腹部盆腔CT检查的必要性。
5例患者有心血管疾病危险因素，其中1例有深静脉血栓形成和肺栓塞个人史，2例有心肌梗死家族史。5例患者早期接受了低分子肝素治疗，1例在症状出现72小时后开始使用肝素。所有病例中，均未观察到对肾功能有影响。
肾梗死虽罕见，但可能被低估，常在已知有心血管疾病的情况下发生。在腹痛综合征面前，越来越多地进行非增强腹部盆腔CT检查，如果未证实结石梗阻，似乎必须通过注射造影剂来完善检查。早期肝素治疗似乎能改善肾功能的完全恢复。
