Martín Martínez J C, Díez Cordero J M, Echenagusia Belda A, Moncada Iribarren I, Durán Merino R, Sánchez-Carreras Aladren F, Bueno Chomon G, Hernández Fernández C
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Arch Esp Urol. 1995 Jul-Aug;48(6):569-78.
To describe a useful algorithm when acute non-traumatic renal artery occlusion is suspected.
The diagnostic and therapeutic aspects of this uncommon disease are analyzed through two cases that had been managed differently.
Early clinical suspicion is based upon a non-colic sudden flank pain in patients with a history of cardiac embolic events, increased serum LDH, ALAT and ASAT, proteinuria, non-lithiasic, non-functioning kidney on IVP and a normal sized non-dilated kidney on ultrasound. The next step is diagnostic angiography and fibrinolysis when indicated.
Intra-arterial fibrinolysis is the treatment of choice in renal artery embolism when functional recovery by angiographic and clinical criteria is present, and will be further enhanced the earlier the diagnosis is made.
描述一种在怀疑急性非创伤性肾动脉闭塞时有用的算法。
通过两例处理方式不同的病例分析这种罕见疾病的诊断和治疗方面。
早期临床怀疑基于有心脏栓塞事件病史的患者出现非绞痛性突发胁腹痛、血清乳酸脱氢酶（LDH）、谷丙转氨酶（ALAT）和谷草转氨酶（ASAT）升高、蛋白尿、静脉肾盂造影（IVP）显示非结石性、无功能肾以及超声显示肾脏大小正常且未扩张。下一步是在有指征时进行诊断性血管造影和纤维蛋白溶解治疗。
当通过血管造影和临床标准显示有功能恢复时，动脉内纤维蛋白溶解是肾动脉栓塞的首选治疗方法，且诊断越早，疗效将进一步提高。
