胡桃夹综合征的研究进展——基于近二十年诊疗模式  

Research progress on nutcracker syndrome:based on the diagnosis and treatment model in recent 20 years

作　　者：王江宜(综述) 王忠[1] 李文智(审校)[1] WANG Jiangyi;WANG Zhong;LI Wenzhi(Department of Urology,Nineth People's Hospital Affiliated to Shanghai Jiaotong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院泌尿外科,上海200011

出　　处：《现代泌尿外科杂志》2021年第12期1076-1081,共6页Journal of Modern Urology

基　　金：上海交通大学医工交叉项目(No.ZH2018QM304)。

摘　　要：胡桃夹综合征(NCS)是左肾静脉受压所导致,临床罕见,表现为血尿、蛋白尿、疼痛等。超声测定左肾静脉内径与流速、或CTA/MRA测定肠系膜上动脉与主动脉夹角是常用的临床诊断方法。对于未成年NCS患者首选保守治疗。若保守治疗效果欠佳,可选择积极干预。干预的措施从以往创伤比较大的血管重建或转流术,逐渐转变为微创的内外支架植入术。具体方案的制定需要考虑患者年龄、症状严重程度以及治疗设施的可及性。近年来3D打印血管外支架植入术因其良好的安全性和有效性成为极具潜力的NCS治疗方法。Nutcracker syndrome(NCS)is a rare disease caused by compression of the left renal vein,which is characterized by hematuria,proteinuria and pain.Ultrasound detection of the diameter and flow velocity of the left renal vein,or measurement of the angle between the superior mesenteric artery and aorta by CTA/MRA are commonly used for diagnosis.For children with NCS,conservative treatment is the first choice.If the effect of conservative treatment is not good,active intervention can be chosen.Surgical intervention has gradually changed from the previous vascular reconstruction or bypass to the minimally invasive surgery,such as internal and external stent implantation.The final treatment plan needs to consider the age of the patients,severity of symptoms,and availability of treatment facilities.In recent years,3D printed extravascular stent implantation has become a promising method due to its excellent safety and effectiveness.

关 键 词：胡桃夹综合征 临床表现 诊疗策略 治疗模式 

分 类 号：R692.1[医药卫生—泌尿科学] R692.6[医药卫生—外科学]