自发性肾周血肿的影像特征与治疗方法的选择

Imaging Features and Treatment Options for Spontaneous Perirenal Hematoma

目的:分析自发性肾周血肿的影像特征与治疗方法。方法:选择1998年7月至2018年7月收治的15例自发性肾周血肿患者,回顾性分析患者临床资料。结果:全部15例患者中,7例患者接受开放手术治疗,包括1例患者接受单纯血肿开窗引流术治疗,1例患者接受根治性肾切除术治疗,5例患者接受肾切除联合血肿清除术治疗。8例患者接受非手术治疗,包括3例患者接受保守治疗,1例患者接受肾动脉栓塞治疗,4例患者接受穿刺引流术治疗。经科学和有效的治疗,13例患者痊愈,并没有出现血肿复发;2例患者死亡。结论:自发性肾周血肿主要发生于肾肿瘤,临床中应结合患者的原发病和出血程度选择合理的治疗方法。

Objective To analyze the imaging features and treatment of spontaneous perirenal hematoma.Methods Fifteen patients with spontaneous perirenal hematoma admitted from July 1998 to July 2018 were retrospectively analyzed.Results Of all 15 patients,7 underwent open surgery,including 1 patient who underwent simple hematoma fenestration,1 patient underwent radical nephrectomy,and 5 underwent nephrectomy combined with hematoma evacuation treatment.Eight patients underwent non-surgical treatment,including 3 patients receiving conservative treatment,1 patient receiving renal artery embolization,and 4 patients receiving puncture drainage.After scientific and effective treatment,13 patients recovered and no recurrence of hematoma occurred;2 patients died.Conclusion Spontaneous perirenal hematoma mainly occurs in renal tumors.In clinical practice,reasonable treatment should be selected based on the primary disease and the degree of bleeding.