摘要
目的探讨肾动脉栓塞引发急腹症的早期诊断和治疗方案。方法大连市中心医院于2007-01～2007-05期间收治的由于肾动脉栓塞引起的急腹症患者3例,均合并有房颤病史。2例行数字减影肾动脉造影确诊为肾动脉主干栓塞,采用尿激酶局部灌注疗法溶栓和血栓抽吸术治疗;1例因肠梗阻、腹膜炎行剖腹探查术,术中发现肾动脉分支栓塞,术后采用尿激酶溶栓、抗凝、祛聚治疗。结果3例患者均在腹痛发生后12h内确诊,2例肾动脉主干栓塞患者经积极的溶栓、取栓治疗后再通,肾血流供应恢复,腹痛症状消失,肾功能正常;1例肾动脉分支栓塞患者溶栓治疗后腹痛症状消失。结论数字减影肾动脉造影是肾动脉栓塞早期诊断最直接可靠的方法,早期尿激酶局部灌注疗法溶栓、血栓抽吸术取栓和抗凝、祛聚等治疗是尽快恢复肾动脉栓塞患者肾脏血流灌注的有效方法。
Objective To explore the diagnosis and treatment of the acute abdomen caused by renal artery embolism（RAE）at the early stage.Methods The 3 cases with RAE were analysed,all of them were complicated by atrial fibrillation.Two were diagnosed as the embolism at the main trunk of the renal artery by digital subtraction angiography,and then were treated by thrombolysis,anticoagulation and transcatheter thrombus aspiration.One case complicated by intestinal obstruction and peritonitis accepted exploratory laparotomy,and we found during the operation the embolism was localized at the branch of renal artery,and was treated by thrombolysis and anticoagulation.Results All of the three cases were diagnosed within 12 hours after the occurrence of abdominal pain.After effective treatments,the abdominal pain disappeared and renal function recovered.Conclusions Digital subtraction angiography of renal artery is the most direct method to diagnose RAE early.Local perfusion therapy,thrombolysis,anticoagulation and transcatheter thrombus aspiration as early as possible are effective method for the recovery of renal perfusion.
出处
《中国急救医学》
CAS
CSCD
北大核心
2008年第1期21-23,共3页
Chinese Journal of Critical Care Medicine
关键词
肾动脉栓塞
急腹症
数字减影肾动脉造影
局部灌注疗法
血栓抽吸术
Renal artery embolism（RAE）
Acute abdomen
Digital substraction angiography of renal artery
Local perfusion therapy
Transcatheter thrombus aspiration
