[1]孙占国,闫 焱,方 毅,等.C臂CT引导的穿刺活检联合动脉栓塞在高出血风险肾肿物诊疗中的应用 [J].介入放射学杂志,2023,32(03):262-265.
　SUN Zhanguo,YAN Yan,FANG Yi,et al.Application of C-arm CT-guided percutaneous puncture biopsy combined with arterial embolization in the diagnosis and treatment of renal mass with high bleeding risk[J].journal interventional radiology,2023,32(03):262-265.
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C臂CT引导的穿刺活检联合动脉栓塞在高出血风险肾肿物诊疗中的应用
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《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
32
期数:
2023年03
页码:
262-265
栏目:
临床研究
出版日期:
2023-03-31

文章信息/Info

Title:
Application of C-arm CT-guided percutaneous puncture biopsy combined with arterial embolization in the diagnosis and treatment of renal mass with high bleeding risk
作者:
孙占国;  闫 焱;  方 毅;  刘一铭;  许凯豪;  韩新巍;  焦德超
Author(s):
SUN Zhanguo;  YAN Yan;  FANG Yi;  LIU Yiming;  XU Kaihao;  HAN Xinwei;  JIAO Dechao.
Department of Interventional Radiology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province 450050, China
关键词:
【关键词】 肾肿物活检;  出血;  C臂CT;  肾动脉栓塞
文献标志码:
A
摘要:
【摘要】 目的 探讨C臂CT引导的肾穿刺活检联合肾动脉栓塞在高出血风险肾肿物诊疗中的安全性和有效性。方法 回顾性分析2011年1月至2021年10月郑州大学第一附属医院介入科行C臂CT引导的肾穿刺活检同步肾动脉栓塞术17例患者的临床资料。均于C臂CT引导的肾穿刺活检同步肾动脉栓塞术后24 h内，完成血常规和凝血功能检查，并与术前指标对比。结果 17例患者中，男11例，女6例，年龄为（66.5±7.0）岁。所有患者均为影像学诊断为肾癌，14例出现远处转移，3例因严重合并症无法耐受手术。高出血风险原因：9例有心脑血管疾病合并症需行抗血小板或抗凝治疗且无法停药，8例合并严重的凝血功能障碍。17例患者均成功取材，病理结果示16例为肾透明细胞癌，1例为乳头状肾细胞癌。术中15例患者出现肾动脉出血需行栓塞辅助治疗，均成功止血。术前术后血红蛋白、红细胞比容、血肌酐、血尿素氮比较，差异均无统计学意义（t=1.97、0.77、0.57、-0.88，均P＞0.05）。结论 C臂CT引导的肾穿刺活检联合肾动脉栓塞是一种安全有效的方法。

参考文献/References:

［1］ Richter F, Kasabian NG, Irwin RJ, et al. Accuracy of diagnosis by guided biopsy of renal mass lesions classified indeterminate by imaging studies［J］. Urology, 2000, 55: 348- 352.
［2］ 王 健，佟小强，杨 敏，等． 活检术后肾出血的超选择性动脉栓塞治疗［J］． 介入放射学杂志， 2008， 17：703- 705．
［3］ 张 翔，刘 丽，梁弦弦，等． 经皮肾穿刺活检术后出血介入栓塞治疗临床效果［J］． 介入放射学杂志， 2021， 30：79- 83．
［4］ Zuo M, Yuan H, Ou S, et al. Superselective transcatheter arterial embolization to control renal hemorrhage after partial nephrectomy for renal tumors: a report of 9 cases and a literature review［J］. J Interv Med, 2019, 2: 134- 138.
［5］ Macginley R,Champion De Crespigny PJ, Gutman T, et al. KHA- CARI guideline recommendations for renal biopsy［J］. Nephrology (Carlton), 2019, 24: 1205- 1213.
［6］ Rouviere O, Bouvier R, Negrier S, et al. Nonmetastatic renal- cell carcinoma: is it really possible to define rational guidelines for post- treatment follow- up［J］. Nat Clin Pract Oncol, 2006, 3: 200- 213.
［7］ Iversen P, Brun C. Aspiration biopsy of the kidney［J］. Am J Med, 1951, 11: 324- 330.
［8］ Gupta R, Cheung AC, Bartling SH, et al. Flat- panel volume CT: fundamental principles, technology, and applications［J］. Radio- graphics, 2008, 28: 2009- 2022.
［9］ Campbell SC,Uzzo RG,Karam JA,et al. Renal mass and localized renal cancer: evaluation, management, and follow- up: AUA guideline part I［J］. J Urol, 2021, 206: 199- 208.
［10］ Lavallee LT, Mcalpine K, Kapoor A, et al. Kidney cancer research network of Canada(KCRNC) consensus statement on the role of renal mass biopsy in the management of kidney cancer［J］. Can Urol Assoc J, 2019，13: 377- 383.
［11］ Fior D，Vacirca F, Leni D, et al. Virtual guidance of percutaneous transthoracic needle biopsy with C- arm cone- beam CT: diagnostic accuracy, risk factors and effective radiation dose［J］. Cardiovasc Intervent Radiol, 2019, 42: 712- 719.

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　XU Wei,ZHOU Tan? yang,WANG Kai? bing,et al. Acute renal hemorrhage： its angiographic manifestations and arterial embolization therapy[J].journal interventional radiology,2013,(03):421.

备注/Memo

备注/Memo:
（收稿日期：2022- 01- 19）
（本文编辑：新 宇）
更新日期/Last Update: 2023-03-28