13例肾错构瘤自发性破裂出血的诊治

目的探讨肾错构瘤破裂出血的诊断和治疗。方法回顾性分析1990～2002年我院诊治的13例肾错构瘤破裂出血的临床资料，所有患者均行B超检查，10例行CT检查，3例行MRI检查。8例行肾切除术，5例行肿瘤剜除术，其中1例因对侧肾错构瘤再次破裂出血行2次手术治疗。结果13例患者术后恢复盎好，5例剜除术患者经6个月～3年的随访，未见复发且肾功能良好。结论B超对诊断肾错构瘤破裂出血是有帮助的，CT和MRI是诊断肾错构瘤破裂出血的较好方法，它们不仅能提示病变的性质而且能确定出血的范围。直径大于4cm的肾错构瘤应积极手术治疗。手术时应尽量保留有功能的肾组织。肾错构瘤破裂出血行肿瘤剜除术是一种较好的选择。

Diagnosis and treatment of renal angiomyolipoma with spontaneous rupture:report of 13 cases

Objective To study the methods for diagnosis and treatment of renal angiomyolipoma with spontaneous rupture.Methods The clinical data of 13 cases with renal angiomyolipoma rupture in our hospital were reviewed.All the patients were examined by ultrasonography.Ten of those were examined by CT scanning and three were examined by MRI.Eight received nephrectomy,five received partial nephrectomy,one of those received partial nephrectomy in other side renal after one side renal had received partial nephrectomy.Results Thirteen patients undergone surgical operation restored to health smoothly,the 5 patients received partial nephrectomy were heathy and had normal renal function.Conclusion Ultrasound is helpful to the diagnosis,CT scanning and MRI is the best diagnostic procedure which may confirm the character of the lesion and the range of bleeding.If the tumour exceeds 4cm,active treatment should be considered.Any operative management should preserve the functional nephrons as much as possible.Partial nephrectomy is a better choise for treatment of renal angiomyolipoma with spontaneous rupture.