腹膜后纤维化24例诊治分析

发布时间：2018-09-09 10:53

【摘要】：目的：总结分析腹膜后纤维化(RF)的临床特征,影像学结果和治疗方法,提高腹膜后纤维化的诊断率。方法：回顾性研究了浙江大学附属第一医院腹膜后纤维化患者的临床资料。结果： 24例RF患者中最常见的首发症状为腰酸腰痛、腹痛。CT或MRJ提示腹膜后软组织影、输尿管管壁增粗或占位,经病理学检查证实15例(62.5%)。24例患者中22例仅行外科干预治疗,1例接受外科干预及出院后糖皮质激素治疗,1例单纯药物治疗。1例术后出现肠瘘,其余23例出院前症状较入院时有不同程度的缓解,肾功能不全的患者肌酐较入院时有不同程度的下降,其中8例血肌酐完全恢复正常。结论：影像学检查是腹膜后纤维化的主要诊断方法。当出现不明原因的双肾积水时,必须考虑腹膜后纤维化可能。外科手术干预是腹膜后纤维化的重要治疗手段,双J管置入术可有效解除输尿管梗阻,为后续进一步诊疗争取时间。
[Abstract]:Objective: to summarize and analyze the clinical features, imaging results and treatment of retroperitoneal fibrosis (RF) in order to improve the diagnostic rate of retroperitoneal fibrosis. Methods: the clinical data of patients with retroperitoneal fibrosis in the first affiliated Hospital of Zhejiang University were retrospectively studied. Results: the most common symptoms in 24 cases of RF were lumbago, abdominal pain. Ct or MRJ showed retroperitoneal soft tissue shadow, and ureteral wall was thickened or occupied. 15 cases (62.5%) were confirmed by pathology, 22 cases were treated with surgical intervention only, 1 case received surgical intervention and 1 case was treated with glucocorticoid after discharge. The other 23 patients had different degrees of remission before discharge, and the creatinine of the patients with renal insufficiency was lower than that of the patients with renal failure, and 8 of them returned to normal completely. Conclusion: imaging examination is the main diagnostic method of retroperitoneal fibrosis. The possibility of retroperitoneal fibrosis must be considered when unexplained hydronephrosis occurs. Surgical intervention is an important treatment for retroperitoneal fibrosis. Double J tube placement can effectively relieve ureteral obstruction and buy time for further diagnosis and treatment.
【学位授予单位】：浙江大学
【学位级别】：博士
【学位授予年份】：2015
【分类号】：R656.4

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