摘要
目的 探讨肾血管平滑肌脂肪瘤 (RAML)自发性破裂的临床表现、诊断和治疗。 方法 肾血管平滑肌脂肪瘤自发破裂 2 3例 ,临床表现突发腰腹疼痛者 2 1例 ,腰部酸胀者 2例 ;其中伴血尿 3例、恶心呕吐 2例、休克 3例、发热 1例。 2 3例B超检查 ,确诊 13例 ;CT检查 2 1例 ,确诊 16例。 结果 术前确诊RAML者 16例 ,术中冰冻切片确诊 2例 ,误诊为肾癌者 4例、肾感染性病变者 1例。行肾切除 10例 ,肾部分切除和肿瘤剜除术各 6例 ,数字减影血管造影 (DSA)加栓塞术 1例。 结论 RAML自发性破裂后常改变临床症状和影像学特征 ,导致误诊和肾切除 ,综合分析临床表现和影像学资料可以提高术前确诊率 ,术中冰冻切片可以避免不必要的肾切除。
Objective To investigate the clinical features,diagnosis and treatment of spontaneous rupture of renal angiomyolipoma (RAML). Methods A total of 23 cases of spontaneous rupture of renal angiomyolipoma were studied retrospectively.The main clinical manifestations were summarized as follows.Sudden and unexpected lumbar and abdominal pain occurred in 21 cases and lumbar swollen pain in 2.Of them 3 cases concomitantly had hematuria.Nausea and vomiting occurred in 2 cases,shock in 3 and fever in 1.All cases underwent B-ultrasonic examination and 21 had CT examination. Results Diagnosis of RAML was established preoperatively in 16 cases,but 4 cases were misdiagnosed for carcinoma of kidney,1 case for renal infectious disease.Two cases were diagnosed by frozen-section sample during operation.Nephrectomy was performed in 10 cases and nephron sparing nephrectomy in 12,and digital subtraction angiography (DSA) embolization in 1. Conclusions Spontaneously ruptured RAML often changes its clinical symptoms and imaging features,which may result in a high misdiagnosis rate and subsequent nephrectomy.Comprehensive analysis of clinical manifestations and image findings can improve preopreative diagnosis rate,and frozen slice sample examination during operation can avoid unnecessary nephrectomy.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2003年第11期728-730,共3页
Chinese Journal of Urology
