摘要
目的:总结256例腹膜后纤维化(RPF)的临床特征,旨在提高对该病的警惕性和早期诊断率。方法:对1971年以来国内文献报道共256例RPF临床资料进行回顾性分析。结果:(1)临床表现和体征:该病男性多见(男女之比为1.84∶1)。平均发病年龄47岁。多以腰背痛、腹痛为首发症状。(2)辅助检查:B超和静脉肾盂造影诊断肾盂和输尿管上段扩张的阳性率分别为84.48%和84.15%;逆行肾盂造影检查对于输尿管有无扩张、狭窄及有无移位等情况的显示明显优于静脉肾盂造影。对于腹膜后占位性病变,B超诊断阳性率为22.37%(49/219),CT为85.32%(93/109),MRI为94.73%(18/19),彩超为100%(8/8);经B超确诊RPF的百分率为6.39%(14/219),彩超为12.5%(1/8),CT为52.29%(57/109),MRI为94.73%(16/19)。(3)病因:在RPF中,特发与继发之比为2.6:1,在继发患者中继发于恶性肿瘤者占64.38%。(4)治疗:内科治疗目前仍以激素为主,晚期需外科治疗。结论:RPF确诊需病理。影像学检查对RPF的诊断与鉴别诊断有重要价值。
Objective：Data of a total of 256 cases with retroperitoneal fibrosis（RPF） reported in the literature in the recent 32 years were reviewed. The purpose of this study was to increase doctors alertness of the disease in order to make the proper diagnosis as early as possible. Methods： The chinical data of 256 cases with RPF reported in the literature in recent 32 years were analyzed retrospectively. Results： （1） RPF was seen in male slightly higher than in female（ 1. 84 ： 1 ）. The mean age was 47 years. Back or flank pain and abdominal pain were most commonly seen. （2） For masses in retroperitoneal space, CT was considered as the first-choice diagnostic method, whose diagnostic rate was much higher than that of B mode ultrasonography（6. 39%）. B mode ultrasonography and intravenous pyelography were more sensitive for renal pelvis and upper ureter. （3） The ratio of idiopathic RPF and secondary RPF is about 2.6：1. Malignant tumors were the major cause for secondary RPF. （4）Cortisone was essential in long-term control. Surgical therapy should be resorted to in the late stage of RPF. Conclusion： Pathological diagnose is the golden standard in diagnose of RPF. Image examination is important in diagnosis and differential diagnosis.
出处
《中国临床医学》
北大核心
2007年第5期738-741,共4页
Chinese Journal of Clinical Medicine
关键词
腹膜后纤维化
诊断
治疗
Retroperitoneal fibrosis
Diagnosis
Treatment
