创伤性内脏动静脉瘘的诊断与治疗

摘要

结合文献回顾性分析讨论1例创伤性肾脏动静脉瘘，探讨创伤性内脏动静脉瘘的临床特点及选择正确的诊断与治疗方法。发现患者腹部刀刺伤后逐渐出现高血压，右腰部有震颤和杂音，DSA、彩超示右肾动静脉瘘并假性动脉瘤、下腔静脉明显扩张，行右肾切除术后震颤和杂音均消失，血压降至正常。认为创伤性内脏动静脉瘘有其独特的临床、影像学特点，DSA、彩超对诊断和治疗方法的选择有重要意义。手术仍是治疗内脏大血管动静脉瘘的主要方法。%To study the clinical presentation and imaging findings ofpatients with t raumatic visceral arteriovenous fistula and select the exact ways for diagnosis and treatment，clinical data of the patie n t with traumatic visceral arteriovenous fistula was retrospectively reviewed.The results showed that the patient had th e classic clinical presentation——murmur and thrill above the place of injury.Ang iography and colour doppler ultrasound s howed a huge right renal arteriovenous f istula，a pseudoaneurysm and an expanded inferior vena cava，the arteriovenous fis tula maybe lay between right renal arter y and right renal vein.The patient under went nephrectomy，got eradication of the clinical sign and symptom without compli cations.This suggested that traumatic vi sceral arteriovenous fistula had special clinical character and imaging evidence .The selection of therapeutic methods de pended on angiography and colour doppler ultrasound.Surgery is still necessary i n huge arteriovenous fistula.