超声引导下冷冻消融术治疗孤立肾肾盂肿瘤1例报告及文献复习

Ultrasound-guided cryoablation for renal pelvic tumor in a solitary kidney(A case repert and review of literature)

目的:探讨孤立肾肾盂肿瘤的微创治疗方法,延缓疾病进展,避免早期透析,提高患者生活质量。方法:对1例孤立肾肾盂肿瘤患者行两次超声引导下冷冻消融术,术后定期行血常规、尿常规、肾功能电解质、泌尿系彩超及CT检查随访。结果:两次冷冻消融术后血尿停止,血红蛋白升高,肾功能电解质无明显变化。第一次消融术后3个月复查泌尿系CT,显示肾盂肿瘤复发;第二次消融术后5个月再次复发,但仍未见淋巴结及远处器官转移,为控制肿瘤生长,转行肾动脉栓塞术及血液透析。结论:采用超声引导下冷冻消融术治疗孤立肾肾盂肿瘤虽未达到根治性治疗目的,但可以在短期内改善血尿症状,缓解患者焦虑情绪,延缓疾病进展,避免早期透析,提高患者生活质量,是孤立肾肾盂肿瘤患者避免肾切除和延缓透析的可选择方法之一。

Objective：To explore the minimally invasive treatment of renal pelvic tumor in a solitary kidney in order to delay disease progression,avoid early dialysis,and improve the patients＇ quality of life.Method：One case of renal pelvic tumor in a solitary kidney was treated with ultrasound-guided cryoablation twice.Postoperative regular follow-up based on blood,urine,renal electrolyte,urinary tract ultrasound and computed tomography.Result：After two procedures hematuria disappeared,and the result of hemoglobin improved.No significant changes in renal electrolyte.Urinary tract CT showed tumor recurrence after three months of first cryoablation,and tumor recurrence was noticed after five months of second cryoablation.However,no lymph node or distant metastasis was found.In order to prevent tumor growth and progression,hemodialysis and renal artery embolization became inevitable.Conclusion：Ultrasound-guided cryoablation for renal pelvic tumor in a solitary kidney fails to achieve radical therapeutic purposes,but it can improve the symptoms of hematuria,delay disease progression,relieve anxiety,protect kidney,avoid early dialysis,and improve the patients＇ quality of life.It can be one of the therapies used in patients with renal pelvic tumor in a solitary kidney.