腹膜后纤维化5例诊治并文献复习

The diagnosis and treatment for 5 cases with retroperitoneal fibrosis and literature review

目的:分析对腹膜后纤维化(RPF)的诊断、治疗状况,提高RPF的早期诊断率。方法:总结5例RPF患者的诊断、治疗和预后情况。结果:5例患者的初发症状各异,但腰背痛、腹痛为多见,后期症状因受累脏器的不同而异,其中以腹部包块、腹腔积液、泌尿系统症状及肠梗阻常见。CT和磁共振成像表现为主要诊断依据,但B超检查有利于合并肾积水及输尿管病变患者的诊断。当疾病在活动期,应积极给予足量激素和免疫抑制剂治疗;当纤维化已形成并发展到梗阻时,需及时手术治疗。结论:腹膜后纤维化发病率低,误诊率高。糖皮质激素对该病效果比较好,后期常需要手术治疗。

Objective：To investigate the status of diagnosis and treatment of retroperitoneal fibrosis （RPF）, to raise the accurately diagnostic rate of RPF. Methods： Analyse diagnosis, treatment and prognosis of the 5 RFP patients. Results：The early symptoms was different, abdomen pain and back pain as main symptoms, advanced stages symptoms to vary with the affected or gan, sees by abdominal mass, ascites, genitourinary tract symptom and obstruction. The main basis of diagnosis is CT and magnetie resonance imaging, but, dopolor ultrasonography was very helpful in diagnosis of kidney with hydronephrosis patients and ureteral diseases patients. In active period of RPF, we shoud give aggressive treatment of adequate glucocorticoids and immuno- suppressant;when fibrosis develops to obstruction, it must be interfered with operation. Conclusion： Such disease is rare and has a high misdiagnosis rate. Glucocorticoids is more effective to RPF, it might need surgery in the late stage.