肾错构瘤78例临床分析

78 Cases Clinic Analysis of Renal Angiomyolipoma

目的：探讨肾错构瘤（RAMI，）的诊断和治疗方法。方法：对78例RAML患者按肿瘤直径分为3组：A组（〈4cm）18例，B组（4～8cm）52例，C组（〉8cm）9例；A组中15例（83％）患者治疗以定期随访为主；B组中40例患者（77％）有临床症状，行保留肾单位手术，10例行肾切除术，2例行肾根治切除术；C组7例（78％）患者有临床症状，均进行了手术治疗，5例行保留肾单位手术，4例行肾切除。结果：所有手术病例术后病理检查均证实为RAML。结论：肿瘤直径〈4cm的患者多无临床症状，可临床随访；肿瘤直径≥4cm的患者应积极行手术治疗，以保留肾单位的手术为首选。

Objective： To explore the diagnosis and treatment of renal angiomyolipoma（RAML）. Methods：Clinical data of 78 cases of renal angiomyolipoma were reviewed retrospectively. The cases were divided in 3 groups based on the size of single largest tumor： Groups A（〈4 cm）, . Groups B（4-8 cm）, Groups C（〉8 cm）. In group A,83%（15/18）of the patients were asymptomatic, regular followed up was primary. In group B, 77% （40/52）had clinical complaints, and nephron-sparing surgery was done in 40 cases,nephrectomy in 10 cases,radical nephrectomy in 2 cases. In group C,78%（7/9）of the patients were symptomatic,all patients acquired surgical operation including nephron-sparing surgery was done in 5 cases, nephrectomy in 4 cases. Results：All cases were confirmed renal angiomyolipoma by pathology after operation. Conclusion： The patient with RAML≥4cm is likely to be asymptomatic and should be observed, while RAML 4 cm,surgery treatment is necessary,and nephron-sparing surgery（NSS） is optimum choice.