肾错构瘤诊断及外科治疗22例.docVIP

肾错构瘤的诊断及外科治疗22例　　作者：刘明勇 李 江 作者单位：天津市第五中心医院泌尿外科，天津 300000 　　【摘要】 目的：探讨肾错构瘤的诊断和外科治疗。方法:回顾性分析2000～2006 年本院诊治的22 例肾错构瘤患者的临床资料,所有患者均行B 超检查,18例行CT 检查,3例行MRI 检查。5例行肾切除术,12例行肾部分切除术，5例行肿瘤剜除术。结果：22例患者术后恢复良好,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。直径大于4 cm 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。 　　【关键词】 肾 肿瘤 诊断 外科手术 　　Diagnosis and surgical treatment of renal hamartoma: a report of 22 cases 　　LIU Mingyong1, LI Jiang2 　　(1.Department of Urology, The Fifth Central Hospital of Tianjin Municipality, Tianjin 300000, China; 　　2.Department of Urology, Tianjin Medical University General Hospital, Tianjin 300052, China) 　　[ABSTRACT] Objective: To study the diagnosis and surgical treatment of renal hamartoma. Methods: Clinical data of 22 patients with renal hamartoma diagnosed and treated from 2000～2006 were studied retrospectively. Examinations of ultrasonography, CT, MRI were undergone in 22 cases,18 cases and 3 cases respectively. 5 patients underwent nephrectomy, 12 patients underwent partial renal resection, 5 patients underwent tumor enucleation. Results: Twenty two patients were successfully undergone surgical treatment with good recovery, 5 patients underwent enucleation of the hamartoma without relapsing according to 6 months to 3 years followup. Conclusions: Ultrasonography plays a valuable role in the diagnosis of hemorrhage of ruptured hamartoma, CT and MRI are the better methods to diagnose hemorrhage of ruptured hamartoma. Hamartoma size larger than 4 cm in diameter should undergo surgical treatment aggressively. Functional renal tissue should be reserved to utmost in the operation. 　　[KEY WORDS] Kidney; Tumors; Diagnosis; Surgical procedures, operative 　　肾错构瘤(renal hamartoma)　又称肾血管平滑肌脂肪瘤(renal angiomyolipoma, RAML) ,是较少见的肾脏良性肿瘤,。虽然该肿瘤生物学行为表现为良性,但易并发自发性破裂出血,引起严重的临床症状,如果诊治不及时可危及患者的生命。本院2000～2006年共收治RAML 患者22例,现报道如下。 　　1 临床资料 　　1.1 一般资料 　　本组22例,男性4 例,女性18例,年龄23～67 岁,平均44.8 岁。肿瘤位于右侧13例,左侧9例 。无症状经查体发现8例，因血尿就诊2例，腰部疼痛就诊7例，因急腹症就诊5例。 　　1.2 影像学检查 　　本