腹膜后纖維化24例診治分析
發(fā)布時(shí)間：2018-09-09 10:53
【摘要】：目的： 總結(jié)分析腹膜后纖維化(RF)的臨床特征,影像學(xué)結(jié)果和治療方法,提高腹膜后纖維化的診斷率。 方法： 回顧性研究了浙江大學(xué)附屬第一醫(yī)院腹膜后纖維化患者的臨床資料。 結(jié)果： 24例RF患者中最常見(jiàn)的首發(fā)癥狀為腰酸腰痛、腹痛。CT或MRJ提示腹膜后軟組織影、輸尿管管壁增粗或占位,經(jīng)病理學(xué)檢查證實(shí)15例(62.5%)。24例患者中22例僅行外科干預(yù)治療,1例接受外科干預(yù)及出院后糖皮質(zhì)激素治療,1例單純藥物治療。1例術(shù)后出現(xiàn)腸瘺,其余23例出院前癥狀較入院時(shí)有不同程度的緩解,腎功能不全的患者肌酐較入院時(shí)有不同程度的下降,其中8例血肌酐完全恢復(fù)正常。 結(jié)論： 影像學(xué)檢查是腹膜后纖維化的主要診斷方法。當(dāng)出現(xiàn)不明原因的雙腎積水時(shí),必須考慮腹膜后纖維化可能。外科手術(shù)干預(yù)是腹膜后纖維化的重要治療手段,雙J管置入術(shù)可有效解除輸尿管梗阻,為后續(xù)進(jìn)一步診療爭(zhēng)取時(shí)間。
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類號(hào)】：R656.4
本文編號(hào)：2232172
[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.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：博士
【學(xué)位授予年份】：2015
【分類號(hào)】：R656.4
【參考文獻(xiàn)】
相關(guān)期刊論文 前1條
1 Nao Fujimori;Tetsuhide Ito;Hisato Igarashi;Takamasa Oono;Taichi Nakamura;Yusuke Niina;Masayuki Hijioka;Lingaku Lee;Masahiko Uchida;Ryoichi Takayanagi;;Retroperitoneal fibrosis associated with immunoglobulin G4-related disease[J];World Journal of Gastroenterology;2013年01期
，本文編號(hào)：2232172
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