両側腎梗塞の1例

Abstract

67歳女, 両側腎梗塞に対し, ウロキナーゼ腎動脈内迅速大量投与及び持続投与が有効であった.両側とも動脈内注入血栓溶解療法で再開通が得られたが, 治療開始の遅れのため造影CT, シンチグラム上では梗塞部の腎機能の回復は得られなかった

A 67-year-old woman was admitted with aching pain in her left flank and nausea. Bilateral renal infarctions were noticed by CT scan and arteriography. Selective intra-arterial thrombolytic therapy was performed. Urokinase (UK) was administered through a balloon catheter embedded into the occlusive segment of the left renal artery selectively. UK (20, 000 units/hour) was continuously infused after short-term high dose UK (360, 000) infusion. In spite of recanalization of the occluded artery, CT scan and renoscintigraphy image did not suggest recovery of renal function. Conservative intra-arterial thrombolytic therapy is considered to be the most effective treatment for renal infarction.