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目的:探讨肾肿瘤自发性破裂出血的影像学特点和诊治方法。方法:对3例肾肿瘤自发性破裂出血患者的临床诊治资料进行回顾性分析,3例均无外伤史及抗凝治疗史,均行B超,CT检查,1例行静脉肾盂造影检查。均经手术后病理证实。结果:3例患者均行开放手术,1例行根治性肾癌切除术,1例行肾部分切除术,另1例行肾切除术。其中1例为肾透明细胞癌,另2例为肾血管平滑肌瘤。结论:肾肿瘤自发性破裂为泌尿外科急症,肿瘤破裂以肾多见,CT可以准确显示出血程度和部位,肾癌破裂出血应行根治性肾切除,肾血管平滑肌瘤应行保留肾单位手术。
Objective: To investigate the imaging characteristics and diagnosis and treatment of spontaneous rupture of renal tumor. Methods: The clinical data of 3 patients with spontaneous rupture of renal tumor were retrospectively analyzed. None of the 3 patients had a history of trauma and anticoagulant therapy. All patients underwent B-mode ultrasonography, CT and venous pyelography. Pathologically confirmed by surgery. Results: All the 3 patients underwent open surgery. One patient underwent radical nephrectomy, one underwent partial nephrectomy and the other underwent nephrectomy. One case of clear cell renal cell carcinoma, and the other two cases of renal vascular smooth muscle tumor. Conclusion: The spontaneous rupture of renal tumor is a urological emergency. The rupture of the tumor is more common in the kidney. CT can accurately show the degree and location of hemorrhage. Radical nephrectomy should be performed on ruptured renal cell carcinoma. Nephron sparing surgery should be performed on renal vascular leiomyoma .