肾血管平滑肌脂肪瘤的诊断与治疗(附30例报告)

The diagnosis and treatment of the renal angiomyolipoma(report of 30 cases)

目的探讨。肾血管平滑肌脂肪瘤（renal angiomyolipoma，RAML）的诊断与治疗方法。方法回顾性分析30例肾血管平滑肌脂肪瘤患者的诊治情况，并复习相关文献。结果肿瘤直径小于4cm而无症状的9例采用B超、CT定期随访观察；手术21例，其中肿瘤直径小于4cm的有伴发症状者8例行肿瘤剜除术；肿瘤直径大于4cm者13例，行肾部分切除术7例，肾切除术6例（其中包括肾血管平滑肌脂肪瘤自发性破裂出血4例）。21例手术患者均获得随访，随访时间6个月～9年，均未见肿瘤复发，肾功能良好。结论肾血管平滑肌脂肪瘤经B超、cT等检查多可明确诊断。治疗方法应根据肿瘤大小、并发症及对肾功能的影响程度来决定，手术应尽可能保留正常肾组织。

Objective To explore the diagnosis and treatment of renal angiomyolipoma. Methods Clini- cal data of 30 patients with RAML was retrospectively reviewed and analyzed. Related references were also re- viewed. Results 9 cases with the tumor＇ s diameter less than 4era and asymptomatic were followed up by Ul- trasound and CT scanning. The other 21 patients accepted operations, 8 patients with the tumor＇s diameter less than 4 cm and asymptomatic underwent tumor enucleation, other 13 paients with the tumor＇s diameter more than 4 cm, 7 cases received partial resection, 6 cases received nephrectomy （including 4 cases with spontaneous bleed- ing）. Conclusions The majority of renal angiomyolipoma can be definitely diagnosed by ultrasonography and CT scanning. The treatment regimen should be depended on the size of the tumor, complications and the degree of im- pairment of renal function, normal kidney tissues should be preserved as many as possible in operation.