本文選題：自發(fā)性 + 腎破裂　； 參考：《吉林大學(xué)》2014年碩士論文

【摘要】：目的：通過對自發(fā)性腎破裂的病因、診斷及治療的分析，探討提高自發(fā)性腎破裂出血的診治效果。 方法：回顧性分析2011年6月—2013年12月期間我院泌尿外科收治的23例自發(fā)性腎破裂出血患者的臨床資料，所有患者均行超聲及CT檢查，2例患者行選擇性腎動脈造影檢查，21例患者行排泄性尿路造影（IVU）檢查。3例患者行腎切除術(shù)，7例患者行根治性腎切除術(shù)，6例患者行保留腎單位手術(shù)（NSS），2例患者行選擇性腎動脈栓塞術(shù)（TAE），1例出血原因不明的患者給予血腫引流術(shù)，1例患者給予行輸尿管鏡碎石取石術(shù)，3例患者給予保守治療。 結(jié)果：本組23例患者均獲隨訪，隨訪時間6～24個月，，其中1例患者于根治性腎切除術(shù)后18個月死于腎癌肺轉(zhuǎn)移，其余患者均健在。12例腎錯構(gòu)瘤患者術(shù)后恢復(fù)良好，術(shù)后復(fù)查均未見腫瘤復(fù)發(fā)。2例腎囊腫患者恢復(fù)良好。2例腎動脈栓塞患者術(shù)后隨訪見腫瘤明顯縮小。1例輸尿管結(jié)石患者術(shù)后恢復(fù)良好，術(shù)后4周拔出輸尿管支架管，定期復(fù)查超聲，腎周積液逐漸吸收。1例病因不明患者未再次發(fā)生自發(fā)性腎破裂出血，定期復(fù)查CT亦未見腫瘤生長。 結(jié)論： 1.自發(fā)性腎破裂出血的主要病因是腎腫瘤，其中以良性腫瘤多見，但應(yīng)警惕惡性腫瘤的可能。 2.超聲和CT在自發(fā)性腎破裂出血的診斷中起到重要作用，術(shù)中快速病理是鑒別腫瘤良惡性的最可靠方法。 3.自發(fā)性腎破裂出血的治療主要根據(jù)原發(fā)病及出血情況，治療方法以手術(shù)治療為主，應(yīng)盡量保留有功能的腎組織。
[Abstract]:Objective: to analyze the etiology, diagnosis and treatment of spontaneous renal rupture and to improve the diagnosis and treatment of spontaneous renal rupture. Methods: the clinical data of 23 patients with spontaneous renal rupture and hemorrhage from June 2011 to December 2013 were retrospectively analyzed. All patients underwent ultrasonography and CT examination. 2 patients underwent selective renal arteriography. 21 patients underwent excretory urography (IVU). 3 patients underwent nephrectomy and 7 patients underwent radical nephrectomy. 6 patients underwent radical nephrectomy. Two patients with renal unit operation (NSS) were treated with selective renal artery embolization (Tae). One patient with unknown bleeding reason was treated with hematoma drainage. One patient received ureteroscopic lithotripsy and 3 patients received conservative treatment. Results: all the 23 patients were followed up for 6 ~ 24 months. One patient died of lung metastasis after radical nephrectomy. The rest patients were alive and well. 12 patients with renal hamartoma recovered well after operation. No recurrence of tumor was found in 2 cases of renal cysts. 2 cases of renal artery embolism were followed up. 1 cases of ureteral calculi recovered well after operation, and 4 weeks after operation, ureteral stents were pulled out. After regular examination of ultrasound, perirenal effusion gradually absorbed 1 cases with unknown etiology. No recurrent spontaneous renal rupture and hemorrhage occurred in the patients, and no tumor growth was found in CT regularly. Conclusion: 1. The main cause of spontaneous renal rupture and hemorrhage is renal tumor, among which benign tumor is more common, but the possibility of malignant tumor should be warned. 2. Ultrasound and CT play an important role in the diagnosis of spontaneous renal rupture and hemorrhage. Intraoperative rapid pathology is the most reliable method for differentiating benign and malignant tumors. The treatment of spontaneous renal rupture and hemorrhage is mainly based on the primary disease and bleeding, the main treatment method is surgical treatment, and the functional renal tissue should be preserved as far as possible.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2014
【分類號】：R699.2

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