MSCT联合多角度DSA在介入治疗急性肾出血中的应用体会(1)
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[摘要] 目的 探讨MSCT联合多角度DSA在超选择性肾动脉栓塞治疗急性肾出血中的应用价值。方法 急性肾出血患者26例，其中a组15例,患者术前行肾脏MSCT平扫增强评估出血原因与部位，术中除常规行后前位DSA造影外，加摄左前斜位(35°～45°或根据CT图像决定)；b组11例患者术前未行MSCT检查，术中仅行后前位DSA造影。对两组对比剂使用量、透视时间及手术时间进行比较分析。结果 全组26例患者即时技术成功率100%，a组术中DSA显示的出血部位与MSCT所见一致。与b组相比，a组在对比剂使用量、透视时间及手术时间方面均有明显减少，差异有统计学意义(P<0.05)。b组2例(18.2%)患者分别于术后第2、3天出血复发再行栓塞止血成功。结论 术前的MSCT平扫加增强扫描结合术中DSA多角度斜位摄影在超选择性动脉插管栓塞治疗急性肾脏出血中是较为合理、可行的操作流程，可以明显减少透视时间及手术时间，减少医患辐射量与对比剂用量，值得在临床推广应用。
[关键词] 体层摄影术，X线计算机；肾脏出血；介入；栓塞
[中图分类号] R692 [文献标识码] B [文章编号] 1673-9701(2011)33-22-03
Application Experience of MSCT Combined with Multi-angled DSA in Interventional Therapy for Acute Renal Bleeding
LU Haihua JIA Yuzhu ZHANG Lingfang CAO Yulin HOU Hongtao
Department of Interventional Radiology, Tongde Hospital of Zhejiang Province, Hangzhou 310012, China
[Abstract] Objective To evaluate the the use vale of MSCT combined with multi-angled DSA in superselective transcatheter renal arterial embolization for acute renal bleeding. Methods Interventional embolization therapy was performed in 26 patients with acute renal bleeding.15 cases of them (group a) received enhanced MSCT scanning to determin the origin of disease and bleeding site followed up with multi-angled DSA beside routine renal arteriography.Others (group b) only received routine renal arteriography.The dosage of contrast medium, the fluoroscopic time and operation time of each patient was analyzed and compared between two groups. Results The instant success rate of hemostasis was 100% in all 26 cases.The bleeding site found in DSA accorded with MSCT in group a. The dosage of contrast medium,the fluoroscopic time and operation time in group a was less than that in the group b,the difference between two groups was statistically significant (P<0.05).2 patients (18.2%) in group b were performed interventional embolization again after 2 or 3 days for hemorrhage relapse. Conclusion Simultaneous use of MSCT and multi-angled DSA is reasonable and practicable in superselective transcatheter renal arterial embolization for acute renal bleeding,which can significantly reduce the dosage of contrast medium,the fluoroscopic time and operation time ......
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