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1、腹膜后纤维化的诊治分析(附48例报告)刘贵中赵耀瑞王勇徐勇孙光蔡启亮王庆杰摘要目的:探讨腹膜后纤维化致上尿路梗阻的临床特点及诊治方法。方法:回顾性分析我院自2006到2012收治的48例腹膜后纤维化患者临床资料,患者常规检查泌尿系彩超、CT,CT提示腹膜后纤维化33例(68.8%),彩超提示腹膜后纤维化18例(37.5%),12例行输尿管松解、腹腔间置术,36例行输尿管插管术,6例行肾穿刺造瘘术。结果:随访6〜60个月,术后患者症状消失24例,肾功能恢复正常27例,36例患者肾积水消失,需要长期透析治疗的
2、患者2例,死亡3例,死亡原因为肾功能衰竭、胃癌晚期。结论:泌尿系CT检查是发现和诊断腹膜后纤维化的主要方法,输尿管松解、腹腔间罝术,输尿管镜插管术,是治疗腹膜后纤维化重要手段,肾穿刺造瘘术是危重患者及输尿管松解术、输尿管插管术失败的补救手术。关键词:腹膜后纤维化:肾积水:输尿管松解、腹腔间置术,输尿管插管术,肾盂穿刺造瘘术。Analysisofdiagnosisandtreatmentofretroperitonealfibrosis(48casesreport)LiuGuizhong,ZhaoYaoru
3、iWangYongXuYongSunGuangCaiQiliangWangQingjie(Departmentofurology,ThesecondhospiatalofTianjinmedicaluniversity)[Abstract]:Objective:Toinvestigatetheretroperitonealfibrosis(RPF)inducedbyupperurinarytractobstructionontheclinicalcharacteristicsanddiagnosismet
4、hod.Methods:retrospectiveanalysisof2006-2012treated48casesofretroperitonealfibrosisandhydronephrosisinpatientswithclinicaldata,patientswithroutineexaminationofurinaryultrasonographyandCT,CTpromptsretroperitonealfibrosisin33cases(68.8%),colorDopplerultraso
5、undtipretroperitonealfibrosisin18cases(37.5%),12casesofureterolysis,36casesofureterintubation,6routinepelvispuncturingfistulation.Results:thepatientswerefollowedupfor6〜60months,postoperativepatientsthesymptomsdisappearedin24cases,renalfunctionreturnedtono
6、rmalin27cases,36casesofpatientswithhydronephrosisdisappeared,requiringlong-termdialysispatients2cases,3casesofdeath,deathduetorenalfailure,advancedgastriccancer.Conclusion:作奍单位:300211天津医科大学第二医院通讯作者:越耀瑞,Emaikzhaoyaorui@sina.comtheurinaryCTinthediscoveryand
7、diagnosisofretroperitonealfibrosisisthemainmethod,ureteralreleasableperitonealinterpositionarthroplasty,ureteralcatheterization,istheimportantmeansoftreatmentofretroperitonealfibrosis,renalfistulizationiscriticallyillpatientsandureterolysis,ureteralintuba
8、tionfailedremedialoperation.Keywords:retroperitonealfibrosis;hydronephrosis;ureterolysis,ureteralcatheterization,pelvispuncturingfistulation.腹膜后纤维化(retroperitonealfibrosis,RPF)是由于腹膜后纤维结缔组织增生,以腹膜后组织慢性非特异性炎症为病理特征的•-•种