肾错构瘤78例临床分析.pdfVIP

实用临床医学2007年第8卷第12期 PracticalClinical Medicine，2007，Vol 8，No12 · 49 · 肾错构瘤78例临床分析 郑增斌，陆金华，钟德平，周劲平，梅 烁，马 欢 (上饶市人民医院泌尿外科，江西 上饶 334000) 摘要：目的：探讨肾错构瘤(RAMI )的诊断和治疗方法。方法：对 78例RAML患者按肿瘤直径分为3组：A组( 4 cm)18例，B组(4～8 cm)52例，c组(8 cm)9例；A组中l5例(83 )患者治疗以定期随访为主；B组中4o例患 者(77 )有临床症状，行保留肾单位手术，lo例行肾切除术，2例行肾根治切除术；C组 7例(78 )患者有临床症 状，均进行了手术治疗，5例行保留肾单位手术，4例行肾切除。结果：所有手术病例术后病理检查均证实为 RAML。结论：肿瘤直径4 cm的患者多无临床症状，可临床随访；肿瘤直径≥4 cm的患者应积极行手术治疗，以 保留肾单位的手术为首选。 关键词：肾错构瘤；诊断；治疗 中圈分类号：R737．11 文献标识码：A 文章编号：1009—8194(2007)12～0049一O3 78 Cases Clinic Analysis of Renal Angiomyolipoma ZHENG Zeng-bin，LU Jin-hua，ZHONG De-ping，ZHOU Jin-ping，MEI Shuo，MA Huan (Department of Urologic，People’5 Hospital of Shangrao，Shangrao 334100，China) Abstract：Objective：To explore the diagnosis and treatment of renal angiomyolipoma(RAML)． Methods：Clinical data of 78 cases of renal angiomyolipoma were reviewed retrospectively．The cases were divided in 3 groups based on the size of single largest tumor：Groups A(4 cm)，． Groups B(4~8 cm)，Groups C(8 cm)．In group A，83 0A(15／18)of the patients were asympto～ matic，regular followed up was primary．In group B，77 (40／52)had clinical complaints，and nephron—sparing surgery was done in 40 cases，nephrectomy in 10 cases，radical nephrectomy in 2 cases．In group C，78 0A(7／9)of the patients were symptomatic，all patients acquired surgical oper～ ation including nephron—sparing surgery was done in 5 cases，nephrectomy in 4 cases．Results：A1l cases were confirmed renal angiomyolipoma by pathology after operation．Conclusion：The pa～ tient with RAML~4 cm is likely to be asymptomatic and should be observed，while RAML≥ 4 cm，surgery treatment is necessary，and nephron—sparing surgery(NSS)is optimum choice． Key words：renal angiomyolipoma；diagnosis；treatment 肾错构瘤(renal angiomyoli