多房囊性肾瘤的临床诊治分析  

Clinical diagnosis and treatment of multilocular cystic nephroma

作　　者：谢燚[1] 李汉忠[1] 纪志刚[1] 刘广华[1] 荣石[1] 石冰冰[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院泌尿外科,北京100730

出　　处：《基础医学与临床》2014年第4期541-543,共3页Basic and Clinical Medicine

摘　　要：目的提高对多房囊性肾瘤的认识,探讨其合理的诊治原则。方法回顾分析6例多囊肾瘤患者的临床资料,结合文献讨论其诊断与治疗。男女各3例,年龄29~51岁。均为体检时发现,2例伴有轻度腰部酸胀,1例合并肉眼血尿,病程10 d^3年。病变均为单侧,其中左右侧各3例,4例病变位于肾下极,2例位于肾上极。6例均行超声检查,5例诊断为囊性占位,囊内见分隔,其中2例合并有钙化,1例诊断为恶性病变。4例行CT检查,3例行MRI检查,均提示病变为肾多发囊性占位,2例可见线样及斑片状强化。1例合并血尿患者IVP示右肾上极肾盏破坏并造影剂外溢。结果6例均行手术治疗,肾部分切除5例。肾根治性切除1例。术后随访1~15年,未见肿瘤复发及转移。结论本病术前诊断依靠B超、CT。手术是治疗主要手段,首选保留肾单位手术。Objective To improve the diagnosis and treatment of muhilocular cystic nephroma. Methods We con- ducted a retrospective analysis, aiming to provide diagnosis and therapy for multilocular cystic nephroma. 6 cases were involved in this analysis, including three males and three females aged between 29 - 51 years old. Among the 6 cases, 3 were asymptomatic, 2 present with backache and 1 with macroscopic hematuria. Course of disease were between 10 days to 3 years. All cases were unilateral, 3 located in the left kidney and 3 in the right. 4 located in the lower pole and 2 in the upper pole. 5 cases were diagnosed with cystic lesions, with septum inside and 2 cases with calcification. 1 case were diagnosed with malignant lesion. 4 cases undergo CT and 3 cases undergo MRI, all indicated multilocular cystic lesions, 2 cases with linear and patchy enhancement in MRI. IVP of the one case with hematuria indicated damage of the calyces and overflow of contrast agents. Results Open surgery had been carried out in all of the 6 patients, including 5 partial nephrectomy and 1 nephrectomy. All the 6 patients had been cured of the disease with no recurrence during the 1 to 15 years＇ of follow up. Conclusions Ultrasonic type B and CT scan- ning are the major means of diagnosis before surgery. Surgery is the main choice of treatment. Nephron-sparing re- section of tumor is a primary and effective therapeutic method for this disease.

关 键 词：肾肿瘤 多房囊性肾瘤 

分 类 号：R737.11[医药卫生—肿瘤]