10例局限型黄色肉芽肿肾盂肾炎诊疗分析并文献复习

Diagnosis and treatment of localized xanthogranulomatous pyelonephritis （report of 10 cases and literature review

目的 探讨局限性黄色肉芽肿性肾盂肾炎的诊断及治疗方法.方法 对2002年至2014年收治的10例局限性黄色肉芽肿性肾盂肾炎患者的临床资料进行回顾性分析,结合文献复习,就其临床表现、影像学特征、诊断及鉴别诊断、治疗等问题进行讨论.结果 本组中CT诊断符合率为：20％,8例患者术前误诊,所有病例均经病理确诊为黄色肉芽肿性肾盂肾炎,10例行手术治疗,其中5例行根治性肾切除术,1例行肾切除术,4例行肾部分切除术,术后效果良好,随访8例至今无1例复发.结论 局限型黄色肉芽肿性肾盂肾炎临床表现复杂多样,缺乏特异性,极易误诊,CT对局限型XGP诊断符合率为20％,手术及抗感染是治疗的主要手段,需根据术前诊断及病变部位,选择合适的手术方式.

Objectives To investigate the diagnosis and treatment of localized xanthogranulomatous pyelonephritis（XGP）.Methods The clinical data of 10 patients with localized XGP were analyzed retrospectively from 2002 to 2014 with review of the literature.The clinical manifestations,imaging features,diagnosis and differential diagnosis,treatment and other issues were discussed.Results Rate of CT diagnosis in the study was 20%,8 cases were misdiagnosed,all cases were pathologically diagnosed as XGP,10 cases were treated by operations,5 cases underwent radical nephrectomy,1 cases underwent nephrectomy,4 cases underwent partial nephrectomy.Follow up 8 cases,all got better effect and without recurrence.Conclusions The clinical manifestation of localized XGP are complex,short of specificity,easily to be misdiagnosed.CT on the localized XGP diagnosis coincidence rate was 20%,operation and anti infection is the main method to cure the disease.According to the preoperative diagnosis and pathological changes,it should choose suitable surgical procedure.