特发性肾包膜下积液的临床研究(附11例报告)  

The clinical study of idiopathic renal subscapular fluid collection: with a report of 11 cases

作　　者：周海永[1] 汪凯[1] 孙吉[1] 范祎[1] 於裕福[1] 

机构地区：[1]浙江萧山医院,浙江杭州311202

出　　处：《腹腔镜外科杂志》2014年第10期739-741,共3页Journal of Laparoscopic Surgery

摘　　要：目的:探讨特发性肾包膜下积液的病因、诊断及治疗方式。方法:回顾分析2010年3月至2013年9月收治的11例特发性肾包膜下积液患者的临床资料,其中女9例,男2例,平均(37.4±6.9)岁,单侧4例,双侧7例,均为初发,患者均于治疗前通过影像学检查排除肿瘤。结果:1例未做任何处理,予以密切随访;3例行后腹腔镜肾包膜切除术,余者行B超引导下穿刺引流术。10例患者手术顺利,围手术期无严重并发症发生。B超引导下引流的患者术后平均随访(30.6±11.7)个月2例复发,再行后腹腔镜手术。行后腹腔镜手术的患者无一例复发。结论:特发性肾包膜下积液为临床罕见疾病,目前病因不明,可通过B超、IVU及CT等影像学检查明确诊断,治疗首选肾包膜下穿刺引流术,如引流术效果不佳时,可考虑行后腹腔镜肾包膜切除术。Objective： To investigate the pathogenesis,diagnosis and treatment of idiopathic renal subscapular fluid collection.Methods： From Mar. 2010 to Sep. 2013,11 patients（ 9 females and 2 males） with idiopathic renal subscapular fluid collection were treated and their clinical data were retrospectively analyzed. Mean age was（ 37. 4 ± 6. 9） years. 4 cases were unilateral,and 7 cases were bilateral,their fluid collections were all primary,tumors were excluded by image examinations before any therapy. Results： One case was treated by active surveillance,3 cases were treated by retroperitoneal laparoscopic renal capsulectomy,the others were operated by B-ultrasound guided puncture and drainage. 10 cases were operated successfully without severe perioperative complications. In a mean follow up for（ 30. 6 ± 11. 7） months,recurrence occurred in 2 patients who underwent B-ultrasound guided drainage,and later they underwent retroperitoneal laparoscopy. No recurrence was found in retroperitoneal laparoscopy. Conclusions： Idiopathic renal subscapular fluid collection is a rare disease,whose cause is still unknown. It can be diagnosed by B ultrasound,IVU and CT. The first choice of therapy is renal subscapular puncture and drainage,if the effect of drainage is poor,the retroperitoneal laparoscopic renal capsulectomy can be chosen.

关 键 词：特发性肾包膜下积液 肾包膜切除术 腹腔镜检查 腹膜后路径 引流术 

分 类 号：R692[医药卫生—泌尿科学]