腹膜后纤维化致急性肾功能衰竭(附2例报告)

目的　总结腹膜后纤维化的临床特征 ,以提高对其的早期诊、治水平。方法　通过文献复习对 2例腹膜后纤维化致急性肾功能衰竭的诊断、治疗和预后进行回顾性分析。结果　原发性腹膜后纤维化致急性肾功能衰竭 1例 ,采用带蒂大网膜包裹治疗 ,随访 9月 ,肾功能正常。继发性腹膜后纤维化致急性肾功能衰竭 1例 ,行肾盂造口 ,肾功能恢复良好 ,6个月后死于癌症广泛转移。结论　逆行肾盂造影是腹膜后纤维化的重要诊断手段 ,确诊需经手术和病理。对继发性腹膜后纤维化应警惕是否合并消化道肿瘤。早期诊断和治疗是减少腹膜后纤维化致急性肾功能衰竭的关键。带蒂大网膜包裹术是有效的治疗方法。

Acute Renal Failure Caused by Retroperitoneal Fibrosis(Report of 2 cases)

Objective To improve the level of early diagnosis and treatment of acute renal failure (ARF) caused by retroperitoneal fibrosis(RPF). Method The diagnosis, treatment and prognosis of the two cases of RPF who had ARF caused by RPF were reviewed. Result RPF causing ARF was idiopathic in 1 and the dissolved ureted was then enveloped with a piece of pediculated omentum, The patient has been followed up for 9 months with normal renal function. The other case was caused by secondary RPF and Pyelostomy was executed. The patient had been followed up for 6 months with normal renal function and died of disseminated gastrointestinal cancer. Conclusion Retrograde urogram plays a very important role in the diagnosis of the condition. The final diagnosis of RPF depends on pathology and surgery. It is suggested that presence of gastrointestinal tumor should be noted in the case of secondary RPF. The early diagnosis and treatment are quite important in decreasing ARF which caused by RPF. Enveloping the dissolved ureter with a piece of pediculated omentum is very effective.