肾血管平滑肌脂肪瘤的诊断与治疗(附72例报告)

目的　探讨肾血管平滑肌脂肪瘤的诊治方法。　方法　总结分析 72例肾血管平滑肌脂肪瘤患者的临床资料。统计学方法采用 χ2 检验。　结果　 13例 (18.1% )术前误诊。诊断正确率B超为 73.6 % (5 3/ 72 ) ,CT为 81.9% (5 9/ 72 ) ,两者同时误诊者 10例 (13.9% )。直径 <4cm的肿瘤误诊率高于≥ 4cm者 ,P <0 .0 5。治疗以保留肾单位的手术为主 ,术前选择性动脉栓塞及术中暂时阻断肾动脉可显著减少出血。　结论　应提高对肾血管平滑肌脂肪瘤的术前诊断水平 ,采取各种措施保留肾单位。

Diagnosis and management of renal angiomyolipoma(report of 72 cases)

Objective The diagnosis and treatment of renal angiomyolipoma were studied. Methods A total of 72 cases of renal angiomyolipoma encountered and treated from Jan. 1983 to Dec. 1999 were reviewed. Results Of the 72 cases, 13 were misdiagnosed preoperatively.The positive diagnosis rate of ultrasonography was 73.6%(53/72) and that of CT 81.9%(59/72).10 cases( 13.9 %) had been misdiagnosed preoperatively with the combined use of ultrasonography and CT.Tumors smaller than 4 cm had a significantly higher misdiagnosis rate( P <0.05).Nephron sparing surgery was the treatment of choice. Preoperative selective renal angioembolization and temporary renal arterial occlusion may reduce blee ding significantly. Conclusions Preoperative diagnostic me thods for renal angiomyolipoma should be improved. Every effort should be made to preserve renal tissue during surgical treatment.