Wang Bin, Wen Chongpei, Song Songlin, Li Guilian, Yan Yanggang, Cheng Shoucai, Zeng Junmei, Lin Zhidong, Wang Yong
Department of Interventional Radiology, The Second Affiliated Hospital of Hainan Medical University, China.
Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, China.
J Interv Med. 2022 Feb 26;5(1):23-27. doi: 10.1016/j.jimed.2021.12.003. eCollection 2022 Feb.
To provide data on the safety and efficacy of renal arterial embolization (RAE) in patients with high-grade blunt renal injury.
Fifteen patients with high-grade blunt renal injury (AAST grades IV-V) admitted to our hospital from July 2014 to December 2019 were retrospectively reviewed in this study. Their clinical success rate and complications were investigated accordingly.
Fifteen patients with high-grade blunt renal injury, 13 men and 2 women with an average age of 41.6 years, including 11 hemodynamically unstable patients and 4 stable patients, were treated with RAE. Among these patients, 73.3% (11 of 15) had grade IV, and 26.7% (4 of 15) had grade V injuries, while 53.3% (8 of 15) patients had concomitant injuries. One patient received main RAE and 14 patients received selective RAE. The clinical success rate after the first embolization was 93.3% (14 of 15). RAE was repeated and was successfully performed in one patient with sustained hematuria. No significant difference in creatinine levels was found before and after embolization. During the follow-up period of 2-82 months, two patients required tube drainage due to urine leaks, one patient developed renal failure requiring renal replacement therapy, and one patient developed secondary hypertension.
RAE can provide a high success rate of hemostasis for both hemodynamically stable and unstable patients with high-grade blunt renal injury, and only minor complications are observed with this procedure.
提供关于肾动脉栓塞术（RAE）治疗重度钝性肾损伤患者安全性和有效性的数据。
本研究回顾性分析了2014年7月至2019年12月我院收治的15例重度钝性肾损伤（美国创伤外科学会IV - V级）患者。相应地调查了其临床成功率和并发症情况。
15例重度钝性肾损伤患者，13例男性，2例女性，平均年龄41.6岁，其中11例血流动力学不稳定，4例稳定，均接受了RAE治疗。这些患者中，73.3%（15例中的11例）为IV级损伤，26.7%（15例中的4例）为V级损伤，53.3%（15例中的8例）患者有合并伤。1例患者接受了主干RAE，14例患者接受了选择性RAE。首次栓塞后的临床成功率为93.3%（15例中的14例）。1例持续性血尿患者接受了重复RAE且成功。栓塞前后肌酐水平无显著差异。在2至82个月的随访期内，2例患者因尿漏需要置管引流，1例患者发生肾衰竭需要肾脏替代治疗，1例患者发生继发性高血压。
RAE可为血流动力学稳定和不稳定的重度钝性肾损伤患者提供较高的止血成功率，且该手术仅观察到轻微并发症。
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