[自发性肾周出血的病因、诊断与处理]

[Etiology, diagnosis and management of spontaneous per renal hemorrhage].

作者信息

Yu Zhi-xian, Xia Guo-ping, Hu Wen-hao, Chen Wei, Li Xiang-bin, Chen Hong-de, Lin Li-zhang, Deng Zhe-xian, Cai Bing, Weng Zhi-liang

机构信息

Department of Urology, First Affiliated Hospital of Wenzhou Medical College, Wenzhou 325000, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2006 Jan 3;86(1):39-41.

PMID:16606534

Abstract

OBJECTIVE

To investigate the etiology, diagnosis, and management of spontaneous perirenal hemorrhage (SPH).

METHODS

The clinical data of 35 patients, 10 males and 12 females, aged 35.9 (12-77), with the diagnosis of SPH, without history of trauma, anticoagulant use, dialysis, and renal transplantation, were analyzed.

RESULTS

The underlying disease of SPH included angiomyolipoma (18 cases), renal cell carcinoma (7 cases), kidney cyst (2 cases), renal artery aneurysm (3 cases), rupture of renal artery aneurysm accompanied with pregnancy (2 cases), renal pheochromocytoma (3 cases 2 of which accompanied with pregnancy), congenital stricture of pelvic ureter junction (1 case), and liver cancer (1 case). The most common underlying diseases were nephrogenic (96%) with angiomyolipoma ranking first (54%) followed by renal cell carcinoma (21%). The underlying diseases were diagnosed correctly in 23 cases (69%). CT helped in diagnosis of 34 cases. Surgery was performed on most of the cases.

CONCLUSION

The most common causes of SPH is renal neoplasms more than 50% of which are benign. Renal artery aneurysm and pheochromocytoma tend to rupture during pregnancy. CT is the first method of choice in diagnosis.

摘要

目的

探讨自发性肾周出血（SPH）的病因、诊断及治疗方法。

方法

分析35例诊断为SPH的患者的临床资料，患者年龄35.9岁（12 - 77岁），男性10例，女性12例，无外伤、抗凝药物使用、透析及肾移植史。

结果

SPH的基础疾病包括血管平滑肌脂肪瘤（18例）、肾细胞癌（7例）、肾囊肿（2例）、肾动脉瘤（3例）、肾动脉瘤破裂合并妊娠（2例）、肾嗜铬细胞瘤（3例，其中2例合并妊娠）、先天性肾盂输尿管连接处狭窄（1例）和肝癌（1例）。最常见的基础疾病是源于肾脏的（96%），其中血管平滑肌脂肪瘤居首位（54%），其次是肾细胞癌（21%）。23例（69%）基础疾病得到正确诊断。CT有助于34例的诊断。大多数病例接受了手术治疗。