肾错构瘤出血的诊断和治疗(附18例报告)

目的 探讨肾错构瘤出血的诊断和治疗方法.方法 2000年6月至2007年12月收治肾错构瘤出血18例患者,经超声、CT等影像学检查后,行开放性手术15例,保守治疗3例.结果 3例患者经保守治疗后出血不再继续,病情趋于稳定.所有手术均顺利完成,无术中大出血及死亡病例.术后病理诊断均为肾错构瘤,无恶变.18例患者均获随诊,随诊时间3个月至5年,随诊时进行超声、CT及IVU检查.行肿瘤剜除术6例患者无肿瘤复发,无继发出血,无尿瘘,IVU提示手术侧肾功能良好.行患肾切除术9例患者对侧肾功能良好.3例保守治疗患者,血肿吸收良好,肿瘤无明显变化.结论 肾错构瘤出血的诊断应结合临床,全面综合分析,超声和CT等影像学检查方法是肾错构瘤出血确诊的主要方法.其治疗方法包括保守治疗、选择性肾动脉栓塞术、肿瘤剜除术或肾部分切除术,出血严重、对侧肾功能正常者,可行患肾切除术.

Diagnosis and treatment of renal angiomyolipoma with hemorrhage (a report of 18 cases)

Objective To investigate the diagnosis and treatment of renal angiomyolipoma with hemorrhage. Methods Eighteen cases of renal angiomyolipoma with hemorrhage were diagnosed by imaging such as ultrasound and CT from June 2000 to December 2007.Open operations were adopted in 15 cases. Expectant treatment was adopted in 3 cases. Results Hemorrhage stopped in 3 cases with expectant treatment.All the operations succeeded.Pathological diagnosis after operations was renal angiomyolipoma.The follow-up time was 3 to 60 months.Ultrasound,CT and intravenous pyelography were mainly methods.There was no case of relapse or fistula.Tumor size of 3 cases with expectant treatment changed little. Conclusions Diagnosis of renal angiomyolipoma with hemorrhage should be based on clinic and imaging.CT and ultrasound have better diagnosis effect.Expectant treatment,selective embolization of renal artery,tumor excision and heminephrectomy are main methods.Nephrectomy can also be adopted when there is serious hemorrhage.