Department of Vascular Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Department of Urology, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People's Republic of China.
Urology. 2014 Jan;83(1):12-7. doi: 10.1016/j.urology.2013.08.033. Epub 2013 Oct 18.
Nutcracker syndrome (NCS), which is caused by compression of the left renal vein between the abdominal aorta and the superior mesenteric artery, leads to a series of clinical symptoms including hematuria, proteinuria, flank pain, and varicocele. The diagnosis of NCS is difficult due to variations in normal anatomy. Treatment, which ranges from observation to nephrectomy, remains controversial. We conducted a review based on the related literature and our experience with hundreds of cases. We summarize the characteristics of NCS, the different measurements used in diagnosis, and the current treatment options. We present our diagnostic criteria and recommend endovascular stenting as the primary option for NCS.
胡桃夹综合征（NCS）是由于左肾静脉在腹主动脉和肠系膜上动脉之间受压引起的，可导致一系列临床症状，包括血尿、蛋白尿、腰痛和精索静脉曲张。由于正常解剖结构的变化，NCS 的诊断较为困难。治疗方法从观察到肾切除术不等，存在争议。我们基于相关文献和数百例病例的经验进行了回顾。我们总结了 NCS 的特征、诊断中使用的不同测量方法以及当前的治疗选择。我们提出了自己的诊断标准，并推荐血管内支架置入作为 NCS 的首选治疗方法。
