双侧肾错构瘤的诊断和治疗(附6例报告)

Diagnosis and treatment of bilatera mutiple renal angiomgolipomas

目的总结双侧。肾错构瘤的诊治方法和治疗效果，进一步提高对双侧肾错构瘤的诊断和治疗水平。方法对2001年至2012年期间在我院就诊的双侧肾错构瘤患者的临床资料和随访结果进行分析。结果共计6例巨大双侧肾错构瘤纳人分析，4例行分期肾部分切除术，1例一期行肾部分切除术，二期行介入栓塞治疗，另1例肿瘤破裂出血，行左肾切除术，但因出血休克死亡。5例患者术后病理检查均确诊为肾错构瘤，术后随访25～36个月，中位随访30个月，均未复发，肾功能仍处于正常范围。结论对于肿瘤未破裂出血的双侧肾错构瘤患者，双侧分期行肾部分切除术是一种安全有效的治疗方法，如行肾部分切除术困难，亦可选择介入栓塞治疗。

Objective To summarize and improve our experiences in diagnosing and treatment of bilateral renal angiomyolipma. Methods We reviewed the clinical data and followed outcomes of patients with bilateral renal angiomyolipma who have received treatment in our hospital between 2001 and 2012. Results Six patients included our study. Four patients received bilateral partial nephrectomy. One patient underwent partial nephrectomy on one side and selective renal artery embolization on the oth- er side. Postoperative pathological examination confirmed the diagnosis of angiomyolipma. One pa- tients who had tumor rupture and severe bleeding received nephrectomy and finally died from shock. The other five patients were a followed from 25 to 60 months （median 30 months） after treatment and no patients got recurrence. Conclusions For patients who have bilateral renal angiomyolipoma, bilateral partial nephrectomy is a relatively safe and effective treatment method and for those partial nephrectomy is difficult, selective renal artery embolization can also be considered.