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导管抽吸配合置管溶栓治疗急性肾梗死的体会

Application of catheter aspiration combined with catheterization thrombolysis in the treatment of acute renal infarction
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摘要 目的探讨导管抽吸配合置管溶栓治疗急性肾梗死(ARI)的安全性及有效性,为治疗此类疾病提供方法上的参考。方法回顾性分析成都市第七人民医院2019年1月—2023年6月收治的11例诊断为ARI并使用导管抽吸配合置管溶栓治疗的患者的临床资料及随访情况。结果11例患者入院时表现为腹痛7例、腰痛5例、恶心5例。所有患者接受导管抽吸配合置管溶栓治疗后症状均消失,溶栓后复查计算机断层扫描血管造影(CTA)可见肾动脉主干及分支血管均恢复通畅,术后1个月患者返院复查肾动脉CTA显示11例患者肾动脉及分支血管、脾动脉分支血管均通畅,检测D2聚体均恢复至正常水平(<0.5 mg/L)。术后3、6、12个月随访患者均未再出现入院时症状,复查彩超或CTA见肾动脉均保持通畅。结论采用导管抽吸配合置管溶栓处理肾动脉内血栓导致的ARI,疗效确切、手术创伤小,值得在临床推广。 Objective To explore the safety and effectiveness of catheter aspiration combined with catheterization thrombolysis in the treatment of acute renal infarction(ARI),so as to provide reference for the treatment of this disease.Methods A retrospective analysis was conducted on the clinical and follow-up data of 11 ARI patients treated with catheter aspiration combined with catheter thrombolysis at our hospital during Jan.2019 and Jun.2023.Results Among the 11 patients,upon admission,7 manifested with abdominal pain,5 with lumbar pain,5 with nausea,and 1 with fever.All patients were successfully treated with catheter aspiration combined with catheterization and thrombolysis.After thrombolysis,computed tomography angiography(CTA)showed the renal artery trunk and branch vessels.In 11 patients,the renal artery,branch artery and splenic artery branch vessels were patent.D2 aggregates returned to the normal level 1 month after surgery(<0.5 mg/L).During the follow-up of 3,6,12 months,no previous symptoms were observed.Ultrasound or CTA showed that the renal artery remained unobstructed.Conclusion The use of catheter aspiration combined with catheter thrombolysis for the treatment of ARI caused by renal artery thrombosis is effective,minimally invasive,and worth clinical promotion.
作者 杨志 王家兴 张杰 杨林 张贯博 李刚 李金凇 蒋世界 YANG Zhi;WANG Jiaxing;ZHANG Jie;YANG Lin;ZHANG Guanbo;LI Gang;LI Jinsong;JIANG Shijie(Department of Vascular Surgery,Chengdu Seventh People s Hospital,Chengdu 610000,China)
出处 《现代泌尿外科杂志》 CAS 2024年第8期708-712,共5页 Journal of Modern Urology
关键词 急性肾梗死 房颤 置管溶栓 血栓抽吸 acute renal infarction atrial fibrillation catheter thrombolysis thrombus aspiration
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