48例腹膜后纤维化诊治分析.doc

腹膜后纤维化48例刘贵中 赵耀瑞 王勇摘要 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2006到2012收治的4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，例行输尿管插管术，6例行肾穿刺造瘘术。结果：随访 ～ 60 个月，术后患者症状消失例，肾功能例，例患者肾积水消失，需要长期透析治疗的患者2例，死亡3例，死亡原因为、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，输尿管松解腹腔间置术输尿管镜术，是治疗腹膜后纤维化重要手，肾穿刺造瘘术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，输尿管术，肾盂穿刺造瘘术。Analysis of diagnosis and treatment of retroperitoneal fibrosis (48 cases report) Liu Guizhong, Zhao Yaorui Wang Yong Xu Yong Sun Guang Cai Qiliang Wang Qingjie (Department of urology, The second hospiatal of Tianjin medical university) [Abstract]: Objective: To investigate the retroperitoneal fibrosis（RPF） induced by upper urinary tract obstruction on the clinical characteristics and diagnosis method. Methods: retrospective analysis of 2006-2012 treated 48 cases of retroperitoneal fibrosis and hydronephrosis in patients with clinical data, patients with routine examination of urinary ultrasonography and CT, CT prompts retroperitoneal fibrosis in 33 cases (68.8%), color Doppler ultrasound tip retroperitoneal fibrosis in 18 cases (37.5%), 12 cases of ureterolysis, 36 cases of ureter intubation, 6 routine pelvis puncturing fistulation. Results: the patients were followed up for 6 ～60 months, postoperative patients the symptoms disappeared in 24 cases, renal function returned to normal in 27 cases, 36 cases of patients with hydronephrosis disappeared, requiring long-term dialysis patients 2 cases, 3 cases of death, death due to renal failure, advanced gastric cancer. Conclusion: the urinary CT in the discovery and diagnosis of retroperitoneal fibrosis is the main method, ureteral releasable peritoneal interposition arthroplasty, ureteral catheterization, is the important means of treatment of retroperitoneal fibrosis, renal fistulization is critically ill patients and ureterolysis, ureteral intubation failed remedial operation. Key words: retroperitoneal fibrosis; hydronephrosis; uretero