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[肾病综合征相关肾静脉血栓形成的治疗]

[Treatment of renal vein thrombosis associated with nephrotic syndrome].

作者信息

Funami M, Takaba T, Tanaka H, Murakami A, Kadokura M, Hori G, Ishii J

机构信息

Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.

出版信息

Nihon Geka Gakkai Zasshi. 1988 Jun;89(6):952-6.

PMID:3185478
Abstract

Renal vein thrombosis is a rare entity in which true incidence is unknown. The disease occurs most frequently in patients with nephrotic syndrome, but it also can occur in the presence of other hypercoagulable state. Two cases of renal vein thrombosis with nephrotic syndrome which were treated by thrombectomy are reported here. One patient was successfully treated by renal vein and inferior vena cava thrombectomy before developing severe pulmonary embolism. The other was treated by renal vein thrombectomy by which fatal shock was able to be prevented. In those cases, immediate operation was indicated, primarily to prevent additional, possibly fatal, pulmonary embolism and also to improve perfusion of the kidney. In the hope of salvaging the kidney, thrombectomy may be the treatment of choice for acute renal vein thrombosis, complication of pulmonary embolism and inferior vena cava thrombosis, right renal vein thrombosis without collateral flow and acute renal vein thrombosis with shock.

摘要

肾静脉血栓形成是一种罕见疾病,其确切发病率尚不清楚。该疾病最常发生于肾病综合征患者,但也可在其他高凝状态下出现。本文报告了两例接受血栓切除术治疗的肾病综合征合并肾静脉血栓形成的病例。一例患者在发生严重肺栓塞之前成功接受了肾静脉和下腔静脉血栓切除术。另一例通过肾静脉血栓切除术治疗,从而预防了致命性休克。在这些病例中,应立即进行手术,主要目的是预防额外的、可能致命的肺栓塞,并改善肾脏灌注。为挽救肾脏,对于急性肾静脉血栓形成、肺栓塞和下腔静脉血栓形成并发症、无侧支血流的右肾静脉血栓形成以及伴有休克的急性肾静脉血栓形成,血栓切除术可能是首选治疗方法。

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