黄色肉芽肿性肾盂肾炎7例分析

摘要

目的 探讨黄色肉芽肿性肾盂肾炎的临床诊断及治疗方法,减少误诊率,提高诊治水平.方法 回顾性分析7例黄色肉芽肿性肾盂肾炎患者的诊治资料,7例均行手术治疗,4例行肾切除术,3例行肾根治切除术.结果 7例患者术中冰冻切片确诊1例,其余6例均为术后病理确诊,经手术治疗全部治愈,术后随访1～4年,未见复发.结论 黄色肉芽肿性肾盂肾炎术前诊断困难,易误诊为其它肾脏疾病;晨尿离心沉渣涂片有泡沫细胞、CT值为低密度值为该病特点,确诊主要靠病理检查.术前诊断为肾脏恶性肿瘤的患者予术中行快速冰冻切片检查有指导意义.治疗上可根据临床分期、病变部位等采取肾切除术为主的治疗方式.%Aim To discuss the diagnosis and treatment of xantho granulomatous pyelonephfitis, in order to reduce the misdiagnosis rate,and to improve the diagnosis and treatment. Methods Retrospective analysis was made of the clinical data of seven cases of xantho granulomatous pyelonephfitis. Among the seven patients who had undergone surgical treatment, four patients got nephrectomy, and the other three got renal radical resection. Results Among the seven cases, there was one case using intraoperative frozen section diagnosis, and the remaining six cases were confirmed pathologically, all the cases cured by surgical operation, and no recurrence after 1 to 4 years of follow-up. Conclusion The preoperative diagnosis of xantho granulomatous pyelonephfitis was difficult, often misdiagnosed as other kidney diseases. The characteristics of the disease was urine smearing with foam cells and of low density in CT film. The disease was diagnosed mainly by pathological examination. Using the rapid intra-operative frozen section examination had a guiding significance for those preoperative diagnosed renal cell carcinoma patients. According to the clinical stage and lesion of the disease, doctors could adopt the nephrectomy based treatment.