| 腹膜后纤维化与肾积水发生关系的临床研究 |
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| 引用本文： | 武睿毅,王国民,孙立安,郭剑明,张立,林宗明.腹膜后纤维化与肾积水发生关系的临床研究[J].中国临床医学,2011,18(3):371-373. |
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| 作者姓名： | 武睿毅 王国民 孙立安 郭剑明 张立 林宗明 |
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| 作者单位： | 复旦大学附属中山医院泌尿外科,上海,200032 |
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| 摘 要： | 目的：探讨腹膜后纤维化（RPF）导致肾积水的原因及诊治经验。方法：回顾分析2004年1月—2010年12月24例腹膜后纤维化致肾积水患者的诊治资料。结果：（1）RPF患者常见首发症状为腰背痛或腹痛（69.2%）;（2）红细胞沉降率（ESR）增快和血清IgG4升高最常见。超声检查仅提示上尿路积水。RPF的静脉肾盂造影（IVP）和CT尿路成像（CTU）表现具有特征性。IVP肾盂输尿管显影不良时,CTU能较清晰的显示上尿路影像。CT扫描发现腹膜后软组织肿块9例（37.5%）,优于超声检查;（3）输尿管松解和腹腔化手术治疗22例;行肾切除术1例;行输尿管置双J管术1例。最终确诊为继发性RPF8例,其中4例为术前诊断,3例为术中腹膜后软组织肿块冷冻活检证实,1例为术后病理证实;（4）特发性RPF手术后肾积水均获长期缓解,而继发性RPF的预后取决于原发疾病及其治疗方案。结论：影像学检查是诊断RPF的重要手段,CTU优于超声检查和IVP。输尿管松解和腹腔化手术可以使特发性RPF输尿管梗阻得到长期的缓解,术中对肿块进行冷冻活检有助于鉴别特发性和继发性RPF,及时调整治疗方案。
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| 关 键 词： | 腹膜后纤维化 肾积水 诊断 治疗 |
Relationship between Retroperitoneal Fibrosis and Hydronephrosis and Its Diagnosis and Treatment |
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| WU Ruiyi,WANG Guomin,SUN Lian,GUO Jianming,ZHANG Li,LIN Zongming.Relationship between Retroperitoneal Fibrosis and Hydronephrosis and Its Diagnosis and Treatment[J].Chinese Journal Of Clinical Medicine,2011,18(3):371-373. |
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| Authors: | WU Ruiyi WANG Guomin SUN Lian GUO Jianming ZHANG Li LIN Zongming |
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| Institution: | WU Ruiyi WANG Guomin SUN Lian GUO Jianming ZHANG Li LIN Zongming Department of Urology,Zhongshan Hospital,Fudan University,Shanghai 200032,China |
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| Abstract: | Objective:To investigate the etiology,diagnosis and treatment of hydronephrosis induced by retroperitoneal fibrosis(RPF).Methods:The medical records of 24 patients with hydronephrosis induced by retroperitoneal fibrosis from January 2004 to December 2010 were reviewed.Results:(1) The most common initial symptom was flank,back,or abdominal pain(69.2%).(2) Elevated erythrocyte sedimentation rate and high serum IgG4 were commom.Ultrasonography only showed hydronephrosis.Features of RPF in intravenous pyelograp... |
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| Keywords: | Retroperitoneal fibrosis Hydronephrosis Diagnosis Treatment |
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