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妊娠期肾血管平滑肌脂肪瘤的栓塞治疗:病例报告

Embolization of renal angiomyolipoma in pregnancy: case report.

作者信息

Bińkowska Małgorzata, Debska Marzena, Mazurek Marzena, Słapa Rafał, Debski Romuald

机构信息

II Klinika Połoznictwa i Ginekologii, Centrum Medyczne Kształcenia Podyplomowego, Warszawa.

出版信息

Ginekol Pol. 2009 Jun;80(6):449-52.

Abstract

BACKGROUND

Renal angiomyolipoma is a rare benign tumour composed of adipose tissue, blood vessels and smooth muscles. However it can locally grow to a great size and its numerous blood vessels may cause major bleeding requiring immediate intervention.

CASE

At 20th week of pregnancy a previously healthy 26-year old pregnant woman with an episode of sudden and severe pain in the left flank followed by fainting was diagnosed with a bleeding tumour of the left kidney. The diagnosis was based on ultrasonography and magnetic resonance imaging (MRI). Diagnostic angiography was followed by selective embolization of the tumour blood vessels. At 38th week of pregnancy elective caesarean section was performed and after the puerperium the tumour was resected.

CONCLUSION

Embolization of renal angiomyolipoma bleeding vessels during pregnancy can be an effective therapeutic approach protecting against further bleeding and haemorrhagic shock thereby obviating the need to perform urgent surgery and allowing the woman to carry her pregnancy to term safely in outpatient setting.

摘要

背景

肾血管平滑肌脂肪瘤是一种罕见的由脂肪组织、血管和平滑肌组成的良性肿瘤。然而,它可在局部生长到很大尺寸,其丰富的血管可能导致严重出血,需要立即干预。

病例

一名26岁既往健康的孕妇,在妊娠20周时出现左腰突发剧痛,随后晕厥,被诊断为左肾出血性肿瘤。诊断基于超声检查和磁共振成像(MRI)。诊断性血管造影后对肿瘤血管进行了选择性栓塞。妊娠38周时进行了择期剖宫产,产褥期过后切除了肿瘤。

结论

妊娠期对肾血管平滑肌脂肪瘤出血血管进行栓塞可以是一种有效的治疗方法,可防止进一步出血和失血性休克,从而避免进行紧急手术,并使孕妇能够在门诊环境中安全地将妊娠维持至足月。

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