囊性肾瘤19例临床诊治分析并文献复习  

Diagnosis and treatment of cystic nephroma and literature review:a report of 19 cases

作　　者：薛孝志 单立平[1] 宋永胜[1] XUE Xiao-zhi;SHAN Li-ping;SONG Yong-sheng(Department of Urology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院泌尿外科,辽宁沈阳110004

出　　处：《现代泌尿外科杂志》2020年第10期915-918,共4页Journal of Modern Urology

摘　　要：目的本文基于囊性肾瘤(CN)患者的临床资料,对CN的诊断与治疗进行分析总结。方法回顾性分析2005年6月至2020年1月中国医科大学附属盛京医院收治的19例CN患者的临床资料。其中成人13例(男8例,女5例),年龄31~62岁,平均年龄(46.462±8.60)岁。儿童6例,包括男3例,女3例,年龄8个月~5岁,平均年龄(1.987±1.55)岁。收集CN患者的Bosniak分级和R.E.N.A.L评分,以及手术方案,随访情况等临床特征。结果19例患者中5例因术前误诊为肾囊肿行肾囊肿去顶减压术,1例因术中冰冻病理提示良性行肾囊肿剔除术,7例因术前误诊为恶性或手术难度大无法保留肾脏行根治性肾切除术或肾切除术,6例行肾部分切除术。11例术后随访1个月~6年无复发和转移。结论影像学检查依然是诊断CN的重要方法,但很难与其他肾多囊性肿瘤相鉴别,可以采用Bosniak分级方法对CN进行评估和处理。结合术中冰冻切片检查有助于诊断。手术方式多采用肾部分切除术,术前可进行R.E.N.A.L评分评估手术难度,选择最佳的手术方式,减少并发症,以达到最大获益。Objective To summarize the diagnosis and treatment of cystic nephroma(CN).Methods The clinical data of 19 CN patients admitted to Shengjing Hospital of China Medical University during June 2005 and Jan.2020 were retrospectively analyzed.There were 13 adults[8 males and 5 females,aged 31-62 years,average(46.462±8.60)years]and 6 children[3 boys and 3 girls,aged 8 months to 5 years,average(1.987±1.55)years].The Bosniak classification and the R.E.N.A.L.nephrometry scoring,surgical plan and follow-up data were collected.Results Of all cases,5 were diagnosed as renal cyst before operation and underwent renal cyst unroofing,1 was found benign during operation and underwent renal cyst excision,7 received unilateral nephrectomy or radical nephrectomy due to misdiagnosis or surgical difficulty,and 6 received partial nephrectomy.During the follow-up of 1 month to 6 years,no recurrence or metastasis occurred.Conclusions Imaging examination is still an important method to diagnose CN,but it is difficult to distinguish CN from other renal polycystic tumors.Bosniak classification can be used to evaluate the condition.Intraoperative frozen section is also helpful for the diagnosis.Partial nephrectomy is the most common surgical method.R.E.N.A.L.nephrometry scoring system can be used to assess the surgical difficulty before operation so as to select the best surgical method to reduce complications and achieve the maximum benefits.

关 键 词：囊性肾瘤 肾肿瘤 肾部分切除术 BOSNIAK分级 R.E.N.A.L评分 

分 类 号：R692.9[医药卫生—泌尿科学]