肾血管平滑肌脂肪瘤临床诊治研究(附48例病例报道)

目的：探讨肾血管平滑肌脂肪瘤(RAML)的诊治方法。方法：回顾性分析48例RAML患者的临床资料及诊治情况。结果：B超37例提示为错构瘤(37／48)，CT38例提示为错构瘤(3895)，7例行MRI检查者6例提示肾错构瘤(6／7)。45例RAML患者行保肾手术，其中10例继发破裂出血者行血肿清除瘤体剜除术；29例瘤体直径大于2cm者行肿瘤切除或肾部分切除术；6例直径小于2cm者行腹腔镜下肿瘤切除术。3例患者行肾切除术。所有病例术后病理检查均证实为错构瘤。结论：B超，CT和MRI为肾错构瘤的最佳诊断方法。对已确诊的肾血管平滑肌脂肪瘤患者应积极进行手术治疗，手术治疗应尽量保留有功能的肾单位。

THE DIAGNOSIS AND TREATMENT OF RENAL LEIOMYOLIPOMA (REPORT OF 48 CASES)

Objective:To discuss the diagnosis and treatment of renal leiomyolipoma.Methods:Clinical data of 48 cases of renal leiomyolipoma were reviewed retrospectively.Results:37/48 of Ultrasonography, 38/45 of computerized tomography, 6/7 of MRI inferred renal leiomyolipoma. Of the 45 cases under going Nephron-sparing surgery, 10 cases with tumor rupture received a renal preserve operation, 29 cases with tumors bigger than 2 cm in diameter received local tumor enucleation or partial nephrectomy. Six cases with tumor less than 2cm in diameter received retroperitional laparoscopy surgery. The other 3 cases underwent nephrectomy. All cases were confirmed by pathology after operation.Conclusion:It is widely accepted that the Ultrasonography, computerized tomography and MRI are the best methods of imaging examination. Active surgical treatment should be considered to renal leiomyolipoma. Any operative management should preserve the functional nephrons as much as possible.