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目的研究肾动脉栓塞对肾肿瘤、肾脓肿和肾出血性疾病的治疗意义。方法采用seldinger法经皮穿刺行股动脉插管,术前辅助肾动脉栓塞治疗肾癌11例和肾脓肿1例,栓塞后2～7天行手术治疗。4例晚期肾癌行肾动脉内化疗加栓塞治疗,4例外伤性肾破裂和1例肾结石术后严重持续血尿,采用明胶海绵或(和)自体血凝块栓塞治疗。结果11例肾癌和1例肾脓肿栓塞后体积缩小,易于切除,术中出血少,无手术并发症。姑息性肾动脉内化疗加栓塞治疗病人疼痛、血尿明显改善,肿块明显缩小。4例晚期肾癌治疗后2例己存活3年以上。9例肾出血性疾病除1例改行开放手术外,余均经栓塞治愈。随访1个月～7年,2例有肾萎缩,其余均正常。结论肾动脉栓塞是治疗肾疾病的一种安全、有效的方法。并发症少,能最大限度保留肾脏。肾动脉内化疗加栓塞安全有效,可用于术前肾癌辅助治疗及晚期肾癌的姑息治疗。
Objective To study the therapeutic effect of renal artery embolization on renal tumors, renal abscess and renal hemorrhagic diseases. Methods Seldinger percutaneous transcutaneous femoral artery catheterization, preoperative adjuvant renal artery embolization in 11 cases of renal cell carcinoma and renal abscess in 1 case, 2 to 7 days after embolization surgery. 4 cases of advanced renal cell carcinoma were treated with chemotherapy and embolization of renal artery, 4 cases of traumatic rupture of kidney and 1 case of severe renal hematuria were treated with gelatin sponge or (and) autologous blood clot embolization. Results In 11 cases of renal cell carcinoma and 1 case of renal abscess, the volume of the renal abscess was reduced, which was easy to excise. There was less bleeding and no complications during operation. Palliative renal artery chemoembolization treatment of patients with pain, hematuria significantly improved mass was significantly reduced. Two of 4 patients with advanced renal cell carcinoma survived more than 3 years after treatment. Nine cases of hemorrhagic disease in addition to 1 case of diverting open surgery, I were cured by embolization. Followed up for 1 month to 7 years, 2 cases of renal atrophy, the rest were normal. Conclusion Renal artery embolization is a safe and effective method for the treatment of renal diseases. Less complications, to maximize the retention of the kidneys. Renal artery chemotherapy and embolization safe and effective, can be used for adjuvant treatment of preoperative renal cell carcinoma and palliative treatment of advanced renal cell carcinoma.