肾血管平滑肌脂肪瘤23例并文献复习

Diagnosis and management of renal angiomyolipoma (report of 23 cases)

摘要:

目的探讨肾血管平滑肌脂肪瘤的诊治方法.方法回顾性分析23例肾血管平滑肌脂肪瘤患者的临床资料并结合文献讨论其诊断与治疗问题.结果术前误诊为肾癌3例,23例均行不同手术治疗,术后病理证实为肾血管平滑肌脂肪瘤,术前选择性肾动脉栓塞或术中低温下阻断肾蒂可显著减少出血和不必要的肾切除.结论B超、CT是诊断本病的主要检查方法,彩超具有较好的良性疾病提示率,术中诊断不明者行多点取材冰冻切片具有重要意义,手术原则是尽可能保留肾单位.

关键词:肾肿瘤;血管肌脂瘤;诊断;治疗

Abstract:

Objective: To study the diagnosis and treatment of renal angiomyolipoma. Methods: Clinical data of 23 cases of renal angiomyolipoma were respectively analysed and discussed with review of the literature. Results: Of the 23 cases, 3 were misdiagnosed preoperatively. Operations were performed on 23 cases and the diagnosis was demonstrated pathologically. Preoperative selective renal-angioembolization and temporary renal arterial occlusion can reduce bleeding and avoid unnecessary nephrectomy significantly. Conclusions: A definite diagnosis of renal angiomyolipoma depends on ultrasound B and computed tomography. Most of the benign space-occupying lesions of kidney could be diagnosed with the combined use of B-ultrasonography, CT and Doppler ultrasonography. Frozen section pathological study during operation should be emphasized.

Key words:kidney neoplasms,angiomyolipoma,diagnosis,treatment