慢性肾盂肾炎加重伴无症状肾血管平滑肌脂肪瘤破裂1例(临床一例)

Mariya V. KAMAEVA
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摘要

本研究致力于研究和分析一个肾脏多发性双侧血管平滑肌脂肪瘤的临床病例。这种肿瘤的形成通常持续数年无症状。病因包括遗传因素、激素衰竭、泌尿生殖系统慢性炎症性疾病等。当肿瘤生长大于5cm时,随着腹膜后出血发展为失血性休克,肿瘤壁自发破裂的风险显著增加。诊断是通过触诊检查、肾脏超声检查、计算机断层扫描、磁共振成像、不透射线血管造影、组织活检和组织学检查进行的。在没有详细的临床表现的情况下,治疗仅限于观察,手术治疗完全根据指征进行。由于血管平滑肌脂肪瘤合并急性或慢性肾脏疾病的无症状病程,在检查的早期阶段进行全面的实验室和仪器诊断是必要的。在极少数情况下,通过以上方法无法诊断血管平滑肌脂肪瘤,因此需要进行计算机断层扫描或磁共振造影。如果肿瘤破裂并形成休克状态,则需要采取复苏措施,然后进行紧急肾切除术或切除肾脏,并在重症监护病房进一步治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Rupture of renal angiomyolipoma with asymptomatic course in a patient with exacerbation of chronic pyelonephritis (clinical case)
This research is devoted to the study and analysis of the clinical case of a patient with multiple bilateral angiomyolipoma of the kidneys. This tumor formation usually proceeds asymptomatically for several years. The causes include hereditary factor, hormonal failures, chronic inflammatory diseases of the genitourinary system. With a tumor growth of more than 5 cm, the risk of spontaneous rupture of the neoplasm wall with the development of retroperitoneal bleeding, which can turn into hemorrhagic shock, significantly increases. Diagnostics is performed by means of palpatory examination, ultrasound examination of the kidneys, computed tomography, magnetic resonance imaging, radiopaque angiography, biopsy with histological examination of tissues. In the absence of a detailed clinical picture, treatment is limited to observation, surgical treatment is carried out exclusively according to indications. With the combined asymptomatic course of angiomyolipoma with acute or chronic kidney diseases, a comprehensive laboratory and instrumental diagnosis is necessary at the early stages of the examination. There are rare cases when it is impossible to diagnose angiomyolipoma by the above methods, therefore it is necessary to conduct computed tomography or magnetic resonance imaging with contrast. In case of rupture of the tumor with the formation of a shock state, it is necessary to carry out resuscitation measures followed by emergency nephrectomy or resection of the kidney and further treatment of the patient in the intensive care unit.
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