Uflacker R, Paolini R M, Lima S
J Urol. 1984 Oct;132(4):662-7. doi: 10.1016/s0022-5347(17)49810-7.
Angiography and selective renal arterial embolization were performed in 17 patients with traumatic lesions of the kidney and hematuria. Of the patients 8 had retroperitoneal extravasation of contrast medium owing to rupture, 6 had traumatic arteriovenous fistulas and 5 had pseudoaneurysms. Immediate control of hemorrhage was achieved in 16 patients (94.1 per cent), while delayed control was obtained in 1. Hematuria recurred in 4 of the 17 patients (23.5 per cent) and resulted in total nephrectomy in 3 (17.6 per cent) despite repeated embolization in 2. Embolization alone was successful in 14 patients (82.4 per cent). According to the followup preservation of renal function and viable parenchyma was excellent in all embolized patients. Our results indicate that transcatheter embolization should be performed in patients with renal trauma and uncontrollable hematuria before any surgical attempt is made.
对17例肾外伤并血尿患者进行了血管造影和选择性肾动脉栓塞术。其中8例因肾破裂出现造影剂腹膜后外渗,6例有创伤性动静脉瘘,5例有假性动脉瘤。16例患者(94.1%)出血得到立即控制,1例为延迟控制。17例患者中有4例(23.5%)血尿复发,其中3例(17.6%)尽管2例进行了重复栓塞仍导致肾全切。单纯栓塞术在14例患者(82.4%)中成功。根据随访结果,所有接受栓塞术的患者肾功能及存活肾实质的保留情况良好。我们的结果表明,对于肾外伤并血尿无法控制的患者,应在任何手术尝试之前进行经导管栓塞术。