双侧肾血管平滑肌脂肪瘤的诊断和治疗

The diagnosis and management of bilateral renal angiomyoli poma

目的 探讨双侧肾血管平滑肌脂肪瘤的诊治方法。 方法 回顾性分析 13例经手术治疗的双侧肾血管平滑肌脂肪瘤患者的诊治资料。男 2例 ,女 11例 ;平均年龄 42岁。术前均经B超和CT检查 ,11例诊断肾血管平滑肌脂肪瘤 ,2例不排除有癌性结节。行单侧保肾手术 5例 ,一期双侧保肾手术 8例。 结果 13例术中快速冰冻和术后病理检查结果均为肾血管平滑肌脂肪瘤。术后 1例血肌酐短暂升高 (3 50 μmol/L) ,2周后降至正常 ;12例肾功能未受影响。 13例随访 1～ 4年 ,肾功能正常 ,肿瘤无复发。 结论 B超和CT是诊断双侧肾血管平滑肌脂肪瘤的重要手段 ,具有独特的影像学特点 ;术中快速冰冻切片检查有助于正确诊断和手术方法的选择 ;手术时应注意保留正常肾组织 。

ObjectiveTo study the diagnosis and trea tm ent of bilateral renal angiomyolipomas.MethodsThe clin ic data of 13 cases of bilateral renal angiomyolipoms were reviewed.There were 2 male and 11 female patients with an average age of 42.Preoperative ultrasonogra phy and CT scanning have been undertaken in all.Renal angiomyolipoma was diagnos ed in 11 and cancer nodules could not be ruled out in the other 2.Unilateral and bilateral renal sparing surgerys were carried out in 5 and 8 cases respectively .ResultsAll cases were examined with rapid frozen sect ion analysis at operations.The renal function of all the patients except 1 was n ormal after operation except 1 with a temporary rise in Scr (350 μmol/L).The pa tients have been followed up 1 to 4 years after discharging from hospital and th e renal function became normal in all.No recurrence was found.Conc lusionsUltrasonography and CT are important methods to diagnose ang iomyolipoma with specific manifestations.Rapid frozen section analysis at operat ions is helpful to diagnose and to choose the correct surgical technique.Attenti on should be paid to reserve the renal tissues as much as possible and renal fun ction should be protected properly.