自发性肾被膜下血肿一例并文献复习  

Spontaneous Perirenal Hemorrhage:A Case Report and Literature Review

作　　者：邢志博[1] 王凤梅[2] 石晶晶[1] 王启堂[1] 

机构地区：[1]青岛大学医学院第二附属医院乳腺科,山东青岛266042 [2]哈尔滨医科大学第二附属医院心内科,哈尔滨150086

出　　处：《临床误诊误治》2013年第9期17-19,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的探讨自发性肾被膜下血肿(spontaneous perirenal hemorrhage,SPH)的临床特点及治疗。方法对我院收治的1例SPH的临床资料进行回顾性分析。结果本例因右侧腹部疼痛5 h入院,按泌尿系结石予相关治疗无明显好转。2 d后复查血常规提示进行性贫血,急诊行双肾CT检查,确诊为SPH。嘱绝对卧床,并予止血、保持尿便通畅、止痛及预防感染等对症处理,病情缓解。2个月后复查超声示肾包膜下血肿消失。结论临床表现不典型、诊断思维局限、缺乏诊断经验及相关影像学检查是导致SPH误诊的主要原因,临床应予以重视。Objective To explore the clinical features and treatment of spontaneous perirenal hemorrhage （SPH）.Methods Clinical data of one patient with SPH in our hospital was retrospectively analyzed.Results The patient was admitted for right abdomen and waist pain for 5 d,and was misdiagnosed as having urinary calculus and failed to response to correlative therapy.Blood routine test showed progressive anemia after 2 d of callback,and SPH was confirmed by CT examination for double kidneys in emergency department.The patient＇s condition improved after corresponding treatments such as absolute bedrest,hemostasis,constipation prevention,analgesia and infection prevention.Renal subcapsular hematoma disappeared in ultrasound examination 2 months later.Conclusion Misdiagnosis may be attributed to non-representative clinical manifestations,limited diagnostic thinking,and lack of awareness and corresponding imaging examination of SPH.

关 键 词：自发性肾包膜下血肿 误诊 尿路结石 

分 类 号：R692.9[医药卫生—泌尿科学]