Kayemba-Kay's S
Paediatrics and Neonatal Medicine Department, Centre Hospitalier du Valais Romand, Sion, Switzerland.
Int J Pediatr Adolesc Med. 2020 Mar;7(1):31-35. doi: 10.1016/j.ijpam.2019.07.001. Epub 2019 Jul 3.
Renal vein thrombosis (RVT) was first described in 1837 by Rayer. Although tremendous progress has been achieved in the comprehension of its pathophysiology, its management remains controversial over 20 decades later. Therapeutic modalities vary from supportive measures alone to the utilization of thrombolytic agents whose protocols are derived from adult medicine. This review aims to show how difficult the treatment of RVT still is, especially with regard to the prognosis. The majority of affected neonates end with various renal complications (renal atrophy, dysfunction, hypertension, etc.). Like others, we suggest that simple unilateral RVT be managed conservatively, while thrombolytic agents may be attempted in unilateral RVT with extension to VCI and in bilateral RVT. Further studies are needed to reach appropriate consensual guidelines.
肾静脉血栓形成(RVT)于1837年由雷耶首次描述。尽管在理解其病理生理学方面已取得巨大进展,但在20多年后的今天,其治疗仍存在争议。治疗方式从单纯的支持性措施到使用源自成人医学方案的溶栓药物不等。本综述旨在表明RVT的治疗仍然多么困难,尤其是在预后方面。大多数受影响的新生儿最终会出现各种肾脏并发症(肾萎缩、功能障碍、高血压等)。与其他人一样,我们建议对单纯性单侧RVT进行保守治疗,而对于扩展至腔静脉的单侧RVT和双侧RVT可尝试使用溶栓药物。需要进一步研究以达成适当的共识指南。