肾盂旁囊肿

Parapelvic cyst of kidney

目的 总结肾盂旁囊肿的临床特征、诊断和治疗方法。 方法 回顾性研究 2 3例肾盂旁囊肿患者的临床资料。 14例 ( 6 1%)有腰部症状 ,4例 ( 17%)有血尿病史 ,4例 ( 17%)伴有高血压病史 ,5例 ( 2 1%)反复出现尿路感染症状 ,9例 ( 39%)无临床症状为体检时发现。 2 3例患者均经B超检查 ,其中 3例为实质性弱回声 ,2 0例为囊性 ,其中 5例为多发性囊肿。 18例行静脉尿路造影检查 ,13例显示肾盂肾盏受压改变 ,5例为正常肾盂肾盏影像。CT检查 18例 ,均表现为肾门附近边缘清晰低密度的圆形影像 ,CT值 2 0Hu以下 ,无增强效应。 结果 15例行手术治疗 ,其中肾切除者 3例 ,包括术前误诊为肾癌而行根治性肾切除 1例 ;其余 12例均行去顶减压术或囊肿切除术 ,术后均经病理证实为囊肿。其余 8例因囊肿小 ,无临床症状而未予处理。 2 0例中 19例 ( 1例未行手术者失访 )获随访 ,随访 0 5～ 12 0年。手术治疗 15例中 ,13例术后腰痛症状消失 ,4例血压高者恢复正常。 结论肾盂旁囊肿诊断上B超因简便易行无损伤而列为首选 ,增强CT时因为囊肿中无造影剂而易与肾积水相鉴别 ,对于囊肿较大 ,有明显腰痛、血尿、高血压等临床症状者应手术治疗。

Objective To study the clinical features,treatment and diagnosis of parapelvic cyst. Methods Twenty-three patients of parapelvic cyst of the kidney were reviewed retraspectively. Fourteen cases(61%) complainted of lumbar pain or discomfort, and 4 patients(17%) accompany hematuria and hypertension. Results In 15 patients receiving surgery, 2 were treated by nephrectomy, one by radical nephrectomy for misdiagnosis. Postoperative diagnosis confirmed a cyst. Eight patients were treated conservatively for cyst being small and without clinical symptoms.Nineteen cases were followed up for 0.5-12.0 years. Conclusions Ultrasonography and CT scan are the main diagnostic methods. Enhanced CT is extremely helpful in differentiat diagnosis of hydronephrosis.Surgical management is suitable for big cysts, lumbar pain,hematuria, hypertension and other complications.