原发性肾紫癜诊治体会（附5例报告）

目的：探讨原发性肾紫癜的诊断和治疗。方法：总结1994～2001年收治经手术和病理证实的肾紫癜5例的临床资料，其中误诊肾盂肿瘤2例，肾结核1例，血尿查因疑肾紫癜2例。结果：5例均行肾脏切除，其中4例因短时内大量出血超过500ml而急诊行肾切除，包括疑肾紫癜还未用上激素治疗的2例。1例反复出血不能排除肿瘤而行肾切。结论：本病的术前诊断比较困难，应结合临床具体分析，尽可能早期用激素治疗以保存肾脏，只有在血尿严重，威胁生命或不排除恶性肿瘤时才考虑行肾切除。

The idiopathic purpura of kidney:Clinical analysis of 5 cases

Objective:To explore the diagnostic and treatment method of the idiopathic purpura of kidney Methods:5 cases of idiopathic purpura of kidney were diagnosed with the surgicopathologic method,and their clinical data were studied:2 cascs has been misdiagnosis as pelvis tumor and 1 case as renal tuberculosis Results:All of 5 cases underwent nephrectomy, among them,4 cases underwent emergent surgery because of massive hemorrhage and 1 case because of repeated hemorrhage and the possibility of tumor which couldn't be excluded Conclusion:It is difficult to make preoperative diagnosis of the idiopathic putpura of kidney.It suggests that nephrectomy is not the first choice in the treatment of idiopathic purpura of kidney, except when acute fatal renal hemorrhage happen and the tumor can't be excluded,while treatment of hormone should be implemented as soon as possible