自发性肾脏破裂

Spontaneous renal rupture

目的探讨自发性肾脏破裂的临床规律。方法总结近年来经治的１６例患者；其中肾癌４例，浸润性结肠癌１例，血管平滑肌脂肪瘤２例，肾囊肿、肾结石、红斑狼疮性（ＳＬＥ）肾炎、肾结核、真性红细胞增多症及门脉高压症各１例，原因不明３例。结果ＣＴ诊断实体病变性自发性肾脏破裂明显优于Ｂ超和静脉肾盂造影。全组手术治疗１１例，其中切肾术６例，保肾术５例，病理报告与术前诊断基本相符；保守治疗５例。结论肿瘤是自发性肾脏破裂的重要病因，ＣＴ对确定出血范围和检出病因颇有实用价值。对病因未明者，定期的薄层ＣＴ的随访性检查是目前较理想的方法。

Objective To study clinical regularity of spontaneous renal rupture. Methods 16 cases of this disease were reviewed.Renal carcinoma was found in 4,angiomyolipoma in 2,undetermined etiology in 3, and invasive colic cancer, kidney cyst, nephrolithiasis,SLE with nephritis, polycythemia vera,renal tuberculosis,portal hypertension in 1 each. Results CT demonstrated a sensitivity of 87 5% in indentifying the underlying kidney mass,which was higher than that (25%) of B type ultrasound and (0) KUB+IVU. Radical nephrectomy was carried out in 6 cases, renal reserved operation in 5,and conservative treatment in 5. Conclusions 60% of spontaneous renal rupture are due to kidney neoplasia.CT scanning is the most valuable diagnostic procedure. If the primary cause has not been clarified, close follow up with periodic CT scanning might be mandatory.