老年腹膜后纤维化26例临床分析

Clinical analysis of retroperitoneal fibrosis in 26 elderly patients

目的探讨老年腹膜后纤维化(RPF)的临床特点和治疗效果。方法分析26例老年腹膜后纤维化患者的临床资料。结果老年RPF的主要临床表现,主要为输尿管梗阻并肾盂积水,肾功能不全,高血压,贫血,腰背痛。实验室检查可见贫血(13例)、白细胞异常(3例)、ESR增快(26例)、血清肌苷及尿素氮增高(22例)、尿蛋白阳性(21例)等。腹部CT及超声检查均提示腹膜后增生性软组织密度影,MRU检查及血管CT检查可发现合并症。病理检查均可见纤维化病变,经手术和激素治疗,死亡15例,存活11例。结论老年人腹膜后纤维化无特异性临床表现,术前诊断主要依据影像学检查,确诊需手术和病理学检查,晚期治疗以解除尿路梗阻为主。

Objective To investigate the clinical characteristics and therapeutic effects of retroperitoneal fibrosis （RPF） in elderly patients. Methods Analyze the clinical materials in 26 elderly patients with retroperitoneal fibrosis. Results The main clinical manifestations of senile retroperitoneal fibrosis included：the retroperitoneal mass and urinary tract obstruction combined hydronephrosis, renal insufficiency, hypertension, anemia and low back pain. The laboratory examination showed there were 13 cases with anemia,3 cases with abnormal white blood ce11,26 cases with accelerating ESR,22 cases with increased serum inosine and BUN,and 21 cases with positive urine protein. The B mode ultrasonography and CT displayed hyperplasia abdominal mass in retroperitoneal. The MRU and CT examination could evaluate the complication. All cases were observed fibrosis with pathological test. After operation and steroid therapy, 15 cases were dead and 11 cases were alive. Conclusion The elderly retroperitoueal fibrosis had no special clinical manifestations, preoperative diagnosis mainly based on imaging examination, and the definite and differential diagnosis depended on pathology and surgery. The surgical therapy could relieve urinary tract obstruction in the late stage of RPF.