CAJ | 학술논문

目的：评价经皮肾动脉栓塞术治疗肾脏肿瘤性出血的安全性及长期有效性。方法12例因肾脏肿瘤导致的出血患者在我科接受了经皮肾动脉栓塞术。肿瘤病变包括肾血管平滑肌脂肪瘤7例，肾癌5例。栓塞用材料包括PVA颗粒和碘油混合物（8例9次），其中2例加用博来霉素；弹簧圈3例，其中2例加用明胶海绵条；单用碘油1例。3例考虑为肾癌的患者在栓塞治疗后接受了外科手术治疗。结果经皮肾动脉栓塞术止血有效率达到100%。在随访中无出血复发患者；1例患者在第一次左肾血管平滑肌脂肪瘤致出血行左肾动脉栓塞术后9个月，因右肾血管平滑肌脂肪瘤腹胀症状明显，又接受了右肾动脉栓塞术。术后未出现严重并发症，出现栓塞后综合征4例，经对症治疗缓解。术后随访中12例患者均接受了影像学检查，包括CT 9例，超声2例，MRI 1例。结论经皮肾动脉栓塞术是治疗肾脏肿瘤性出血的安全有效方法，其随访显示长期治疗效果确切。
목적：평개경피신동맥전새술치료신장종류성출혈적안전성급장기유효성。방법12례인신장종류도치적출혈환자재아과접수료경피신동맥전새술。종류병변포괄신혈관평활기지방류7례，신암5례。전새용재료포괄PVA과립화전유혼합물（8례9차），기중2례가용박래매소；탄황권3례，기중2례가용명효해면조；단용전유1례。3례고필위신암적환자재전새치료후접수료외과수술치료。결과경피신동맥전새술지혈유효솔체도100%。재수방중무출혈복발환자；1례환자재제일차좌신혈관평활기지방류치출혈행좌신동맥전새술후9개월，인우신혈관평활기지방류복창증상명현，우접수료우신동맥전새술。술후미출현엄중병발증，출현전새후종합정4례，경대증치료완해。술후수방중12례환자균접수료영상학검사，포괄CT 9례，초성2례，MRI 1례。결론경피신동맥전새술시치료신장종류성출혈적안전유효방법，기수방현시장기치료효과학절。
ObjectiveTo evaluate the safety and efficacy of percutaneous renal artery embolization for treatment of hemorrhage caused by renal tumor.Methods12 consecutive patents underwent renal artery embolization to treat hemorrhage caused by renal tumor. There was 7 cases with renal angiomyolipoma and 5 cases with renal carcinoma. The embolism materials used consisted of polyvinyl alcohol particles/lipiodol mixture in 8 cases, coils with gelatin sponge in 3, lipiodol in 1. 3 of the 5 cases diagnosed as renal carcinoma underwent surgery and were pathologically confirmed as malignancy. Results The success rate for hemostasis was 100% in our series. One patient required a subsequent embolization of the right kidney 9 months after the initial embolization of the left kidney. No rebleeding occurred in all the cases during the follow up. Medical imaging modalities including computed tomography (n=9), ultrasound (n=2), and magnetic resonance (n=1) were performed during the follow up.Conclusion Percutaneous renal artery embolization is an effective treatment for hemorrhage caused by renal tumors. Clinical outcome is durable according to long-term follow up results.