腹膜后纤维化致肾积水的诊治(附8例报告)

Diagnosis and treatment of hydronephrosis induced by retroperitoneal fibrosis

目的 :探讨腹膜后纤维化 (RPF)致肾积水的诊断与治疗方法 ,以提高本病的早期诊治率。方法 :通过影像学检查进行诊断和鉴别诊断 ,根据情况选择保守治疗或手术治疗。结果 :保守治疗可延缓或阻止病变发展 ,手术治疗可明显改善症状 ,挽救肾功能。结论 :对B超检出的肾积水患者 ,特别是伴输尿管上段积水者 ,要考虑到RPF ,需进一步行静脉肾盂造影检查 ,CT及MRI对病变范围、程度以及多结构受累比较准确。早期病变以保守治疗为主 。

Purpose:To improve the diagnosis and treatment of retroperitoneal fibrosis induced hydronephrosis.Methods:Data of 8 cases were reviewed retrospectively. All patients were subjected to image analysis for diagnosis and differential diagnosis. 2 cases received preserved therapy and 6 cases were operated on according to the specific cause of the disease.Results:Preserved therapy could postpone or stop the development of pathological changes. Operative treatment could obviously improve the symptom and save renal function. Conclusions:For Patients with hydronephrosis identified by B type ultrasonography, especially for those with dilated upper ureter segments, diagnosis of retroperitoneal fibrosis should be considered and further excretory urography is necessary. CT scan and MRI are reliable and accurate in determining the scope extent and multi- structural involvement of pathological changes. Preserved therapy is more advisable at the early disease and operation is the choice of treatment for advanced disease.