CAJ | 학술논문

目的探讨腹膜后纤维化(RPF)致肾积水的诊断与治疗方法,以提高本病的早期诊治率.方法回顾性分析1998～2008年间所收治的5例腹膜后纤维化致肾积水患者的临床资料,其中原发性者3例,继发性者2例;通过影像学检查进行诊断和鉴别诊断;1例行双侧输尿管内支架管+他莫昔芬治疗,1例给予糖皮质激素治疗,3例行输尿管松解术或输尿管松解加大网膜包裹术并于术前、术后加用激素治疗.结果随访3～48个月,1例继发于胃癌者于术后3个月死亡;4例治疗后血沉降至正常,肾积水基本消失或明显减轻,随访期间未见复发.结论对于不明原因的肾积水患者,应考虑到RPF的可能;B超、CT、MRI、逆行肾盂造影等检查对RPF的诊断和鉴别诊断有重要价值;早期病变可给予药物治疗,中晚期病变以手术治疗为主;血沉可作为判断疾病活动和治疗效果的指标.
목적 탐토복막후섬유화(RPF)치신적수적진단여치료방법,이제고본병적조기진치솔.방법 회고성분석1998～2008년간소수치적5례복막후섬유화치신적수환자적림상자료,기중원발성자3례,계발성자2례;통과영상학검사진행진단화감별진단;1례행쌍측수뇨관내지가관+타막석분치료,1례급여당피질격소치료,3례행수뇨관송해술혹수뇨관송해가대망막포과술병우술전、술후가용격소치료.결과 수방3～48개월,1례계발우위암자우술후3개월사망;4례치료후혈침강지정상,신적수기본소실혹명현감경,수방기간미견복발.결론 대우불명원인적신적수환자,응고필도RPF적가능;B초、CT、MRI、역행신우조영등검사대RPF적진단화감별진단유중요개치;조기병변가급여약물치료,중만기병변이수술치료위주;혈침가작위판단질병활동화치료효과적지표.
Objective: To investigate the diagnosis and treatment of hydronephrosis caused by retroperitoneal fibrosis. Methods: A retrospective study from 1998 up to 2008, for the diagnosis and treatment of 5 cases of hydronephrosis caused by retroperitoneal fibrosis was made. Results: One patient secondary to malignancy died in 3 months after operation. The other patients were followed up for 3 to 48 months with the involved kidneys normal in size and shape. Conclusion: Retro-peritoneal fibrosis should be considered in hydronephrosis without agent. B mode uhrasonography, CT , MRI and retrograde urogram are very important in the diagnosis. Drug therapy is only used in the early stage of RPF, while surgical therapy should be resorted for advanced disease.