结节性硬化症患者巨大肾错构瘤破裂出血1例救治体会并文献复习

doi:10.3969/j.issn.1004-583X.2024.12.009

临床荟萃 ›› 2024, Vol. 39 ›› Issue (12): 1111-1114.doi: 10.3969/j.issn.1004-583X.2024.12.009

结节性硬化症患者巨大肾错构瘤破裂出血1例救治体会并文献复习

贾敏楠¹, 刘琼², 徐若云¹, 牛凯²()

1.河北医科大学研究生学院,河北石家庄 050017
2.河北省人民医院肾内科,河北石家庄 050051

收稿日期:2024-02-17 出版日期:2024-12-20 发布日期:2025-01-10
通讯作者: 牛凯,Email: betterman12345@126.com

Treatment experience of giant renal hamartoma rupture and hemorrhage in a patient with tuberous sclerosis complex and literature review

Jia Minnan¹, Liu Qiong², Xu Ruoyun¹, Niu Kai²()

1. Graduate School of Hebei Medical University,Shijiazhuang 050017,China
2. Department of Nephrology,Hebei General Hospital,Shijiazhuang 050051,China

Received:2024-02-17 Online:2024-12-20 Published:2025-01-10
Contact: Niu Kai,Email: betterman12345@126.com

摘要/Abstract

摘要：

目的探讨巨大错构瘤成因及有效治疗手段。方法回顾性分析1例巨大肾错构瘤破裂出血的结节性硬化患者的诊疗经过,并复习国内外相关文献。结果该患者巨大肾错构瘤破裂出血,行动脉栓塞术,术后发热合并急性肾损伤,评估再出血风险较高,行肾脏切除手术治疗。结论结节性硬化症合并肾错构瘤不易引起肾功能异常,针对破裂出血患者,主要治疗手段为保守治疗或介入栓塞治疗。该疾病具有家族遗传性,早期诊断及监测至关重要。

关键词: 结节性硬化症, 肾错构瘤, 介入栓塞治疗

Abstract:

Objective To explore the causes and effective treatment of giant hamartomas. Methods The diagnosis and treatment of 1 case of nodular sclerosis with giant renal angiomyolipoma rupture and hemorrhage were retrospectively analyzed, and the relevant literatures at home and abroad were reviewed. Results The patient was treated with arterial embolization due to rupture and bleeding. After surgery, the patient developed fever and acute kidney injury, with a high risk of rebleeding that requires a renal resection. Conclusion Tuberous sclerosis combined with renal hamartoma is not likely to cause abnormal renal function. For patients with rupture and bleeding, conservative or interventional embolization is preferred. The disease is hereditary in families, and early diagnosis and monitoring are essential.

Key words: tuberous sclerosis, renal hamartoma rupture, interventional embolization

中图分类号:

R742.89

贾敏楠, 刘琼, 徐若云, 牛凯. 结节性硬化症患者巨大肾错构瘤破裂出血1例救治体会并文献复习[J]. 临床荟萃, 2024, 39(12): 1111-1114.

Jia Minnan, Liu Qiong, Xu Ruoyun, Niu Kai. Treatment experience of giant renal hamartoma rupture and hemorrhage in a patient with tuberous sclerosis complex and literature review[J]. Clinical Focus, 2024, 39(12): 1111-1114.

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链接本文: https://huicui.hebmu.edu.cn/CN/10.3969/j.issn.1004-583X.2024.12.009

https://huicui.hebmu.edu.cn/CN/Y2024/V39/I12/1111

图/表 2

图1 胸部CT:双肺多发含气囊腔,双肺背侧肺不张(箭头所示)

Fig. 1 Chest CT: multiple air sac cavities in both lungs, atelectasis on the dorsal side of both lungs (shown by the arrow)

图2 肾脏CT:双肾多发类圆形脂肪密度影,较大者位于右肾,约286 mm×157 mm×129 mm(箭头所示)

Fig.2 Kidney CT:multiple round-like fat density shadows in both kidneys. The larger one is located in the right kidney, about 286 mm×157 mm×129 mm(shown by the arrow)

参考文献 25

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结节性硬化症患者巨大肾错构瘤破裂出血1例救治体会并文献复习

Treatment experience of giant renal hamartoma rupture and hemorrhage in a patient with tuberous sclerosis complex and literature review

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