肾素瘤临床诊治分析

Diagnosis and treatment of reninoma

目的:探讨肾素瘤的诊断与治疗。方法:回顾性分析2010年1月~2015年2月收治的10例肾素瘤患者的临床表现、诊断方法、手术方式、病理结果及预后情况。结果:10例表现为高血压,5例为低血钾,1例为查体发现。10例患者中,7例行后腹腔镜保留肾单位手术,2例行后腹腔镜根治性肾切除术,1例行开放性保留肾单位手术。术后病理报告均为肾素瘤,均获随访,随访时间4~61个月,中位随访时间18.5个月,10例患者术后复查血钾、肾素、醛固酮水平均正常,高血压症状也有不同程度的缓解或恢复正常,所有患者均未见肿瘤复发和转移。结论:肾素瘤为良性肿瘤,表现为高血压、低血钾、高肾素血症、高醛固酮血症等临床特点,手术治疗是首选治疗方式,预后良好。

Objective:To discuss the diagnosis and treatment of reninoma.Methods:The clinical data such as manifestations,diagnosis,surgical approaches,pathology and prognosis of 10 cases of reninoma treated from January 2010 to February 2015 were analyzed retrospectively.Results:All of the 10 cases had hypertension,5cases had hypokalemia,and 1case was detected by physical examination.Retroperitoneal laparoscopic partial nephrectomy was performed on 7cases,retroperitoneal laparoscopic radical nephrectomy on 2cases,and open nephron-sparing surgery on 1case.Postoperative pathological examination of all cases confirmed reninoma.All cases were followed up.The median follow-up time was 18.5 months.Postoperative checks about potassium,renin,and aldosterone were normal,and hypertension was improved or recovered,but there was no recurrence or metastasis.Conclusions:Reninoma is characterized as benign tumor with hypertension,hypokalemia,hyperreninemia,and hyperaldosteronism.Surgery is the preferred treatment for this tumor.It has a favorable prognosis.