5例继发性腹膜后纤维化诊治分析

目的继发性腹膜后纤维化(retroperitoneal fibrosis,RPF)发病率低,临床缺乏特征性表现,早期诊断困难,常致误治。通过总结分析后,旨在提高对该病的早期诊断率。方法回顾性分析继发于胃肠道手术后RPF5例患者的诊疗经过进行总结分析。结果继发于恶性肿瘤行肠梗阻转流术3例和乙状结肠造瘘术1例后于3~13周内死亡,继发于外伤性行肠梗阻转流后效果良好。结论遇到患者腹部手术后1~3个月之间,如出现主诉模糊不清和出现不同程度的腹、腰背疼痛或腹部肿块,而临床上又不能用某些疾病进行解释时,应考虑到RPF的可能。B超可以了解肾盂积水情况,CT和MRI检查对RPF的诊断和鉴别诊断有重要价值。非恶性肿瘤的RPF在炎症活动期应内科治疗,晚期出现腹膜后空腔脏器梗阻时则需外科手术治疗,而继发于恶性肿瘤者预后极差。

Retroperitoneal fibrosis:report of 5 cases

Objective Because of lowness of incidence of a disease,absence in clinical characteristic manifest and difficulty of diagnose in forepart,retroperitoneal fibrosis(RPF)treatmeat can be delayed.The purpose of this paper is to analyze the clinical manifestations,so that diagnosis and treatment may be made as early as possible.Methods 5 cases of retroperitoneal fibrosis (RPF) after gastroenteric operation in recent 6 years reviewed.Results 3 cases of retroperitoneal fibrosis (RPF) with maligant tumor were underwent ileus transfer,and 1 case underwent sigmoid flexure,died within 1-13 weeks.One case with traumatic was underwent ileus transfer. The curative effect is better.Conclusion The initial symptom of RPF is quite variable. But back or flank pain,abdominal pain and oliguria with physical signs of either swollen leg or abdominal mass are most commonly seen.B mode ultrasonography is a more sensitive method for the involvement of renal hydrocele.For diagnosis of RPF,CT and MRI should be first considered.Drug therapy is only used in the early or middle stage of RPF with no-malignant tummer,while surgical therapy should be resorted in the late stage of RPF.For retroperitoneal fibrosis(RPF) with malignant tummer,prognosis is very bad.