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肾囊肿微创治疗3天痊愈。

2019年10月21日 8263人阅读 返回文章列表

Treatment for renal cyst operation -- not healed in three days

肾囊肿括单发性肾囊肿、先天性多囊肾和先天性多发性肾囊肿等。这种囊肿的壁很薄,囊内为澄清带黄色的液体,囊肿大多为核桃大小。近来由于B超检查的广泛开展,所以发现有肾囊肿者也增多了。       

Renal cysts including solitary renal cyst and polycystic kidney and multiple congenital cyst etc.. The cyst wall is very thin, in the capsule is clarified with yellow liquid, cysts are mostly the size of a walnut. Due to the recent B-ultrasound extensively, so found renal cysts has increased.

The main clinical symptoms of kidney cyst of the vast majority of asymptomatic renal cyst. Some patients may be increased, due to pressure the cyst itself and intracystic infection and the emergence of the following conditions:

The waist, abdominal discomfort or pain: the reason is because the kidneys were enlarged and dilated, the renal capsular tension increases, renal pedicle is pulled pull, or to adjacent organs caused by pressure. In addition, polycystic renal cause kidney contains a large quantity of water, become heavy, straining pull, will also cause the waist pain. Characteristics of pain as pain, dull pain, fixed in one or both, to the lower part and the back radiation. As a secondary infection intracystic hemorrhage, will make the pain suddenly intensified. Such as the merger of stones or bleeding after clot obstruction of the urinary tract, can appear renal colic.

②血尿:可表现为镜下血尿或肉眼血尿。发作呈周期性。发作时腰痛常加剧,剧烈运动、创伤、感染可诱发或加重。出血原因是因为囊壁下方有许多动脉,由于压力增加或合并感染,使囊壁血管因过度牵拉而破裂出血。

The hematuria: can behave for microscopic hematuria or gross hematuria. The attack was periodically. At the onset of back pain often intensifies, strenuous exercise, trauma, infection can induce or aggravate. Bleeding reason is because the capsule wall below there are many arteries, due to increased pressure or combined infection, make cyst wall blood vessels due to excessive traction and rupture.

③腹部肿块:有时为患者就诊的主要原因,60%~80%的患者可触及肿大的肾脏。一般而言,肾脏愈大,肾功能愈差。

The abdominal mass: sometimes as the main reason of visiting patients, 60% to 80% of patients with palpable enlargement of the kidney. In general, the greater the kidney, the renal function worse.

④蛋白尿:一般量不多,24小时尿内不会超过2g。多不会发生肾病综合征。

The proteinuria: general quantity is not much, 24 hours urine within not more than 2g. The occurrence of the nephrotic syndrome is not.

⑤高血压:因为囊肿压迫肾脏,造成肾缺血,使肾素分泌增多,引起高血压。在肾功能正常时,已有50%以上患者发生高血压,肾功能减退时,高血压的发生率更高。

The hypertension caused by renal cyst: because of the oppression, renal ischemia, the renin secretion, cause high blood pressure. In patients with normal renal function, has more than 50% of hypertension, renal insufficiency, hypertension, the incidence of higher.

⑥肾功能减退:由于囊肿占位、压迫,使正常肾组织显著减少,肾功能进行性减退。

The decline in renal function: the cyst occupying, oppression, so that normal renal tissues significantly reduced renal function loss.

肾囊肿的检查方法 比较可靠的方法有X线造影、肾脏B型超声检查、放射性核素扫描及CT检查。在肾囊肿时,泌尿系X线造影可能见到肾盂、肾盏受压变形,但边缘光滑,无破坏。肾囊肿不是肿瘤,但极易与肿瘤相混淆,因此肾囊肿与肾恶性肿瘤的鉴别十分重要。二者的鉴别方法可用肾实质性断层造影或肾动脉造影。肾实质断层摄影时,囊肿部位影像浅,肿瘤部位影像深;肾动脉造影时,囊肿部位血管稀疏,无造影剂浓聚,肾恶性肿瘤则因血管丰富,有造影剂浓聚。怀疑囊肿恶性变时,可进行囊肿穿刺,抽出囊液进行常规检查及脱落细胞检查;也可向囊肿内注入造影剂,检查囊壁有无肿瘤。B型超声和CT很容易将肾囊肿和肾实质性肿瘤区别开来 。

Methods examination methods of renal cysts are the reliable X-ray angiography, renal B type ultrasound, radionuclide scanning and CT examination. In the kidney cyst, X-ray urography could see the renal pelvis, calyces compression deformation, but the edge smooth, no damage. Cyst of kidney is not a tumor, but easily confused with tumor, so the differential renal cysts and renal malignant tumor is very important. The identification method of the two available renal parenchymal tomography or renal artery angiography. Renal cyst tomography, site image shallow, tumor position imaging depth; renal artery angiography, cyst sites of vascular sparse, no contrast agent concentration, kidney malignant tumor due to vascular rich, there is a contrast agent concentration. Suspected cyst malignant change, can make cyst puncture, aspirated fluid routine inspection and examination of exfoliated cells; also can be injected with a contrast agent to cyst, cystic wall has no tumor examination. B type ultrasound and CT are easy to be renal cysts and renal parenchymal neoplasms distinction.

肾囊肿的治疗方法 目前的医学水平还没有治疗肾囊肿的特效方法。

Still do not have specific methods for the treatment of renal cyst treatment of renal cysts present medical level.

1、对于小的肾囊肿,无症状时不需要做任何治疗,但要定期复查,观察囊肿是否继续增大。无症状者应经常进行尿液检查,包括尿常规、尿培养,每半年至一年进行一次肾功能检查,包括内生肌酐清除率。

1, for small renal cysts, no symptoms do not need to do any treatment, but should check regularly, to observe whether to continue increasing cyst. Asymptomatic persons often should undertake examination of urine, including urine, urine culture, a kidney function tests every six months to one year, including endogenous creatinine clearance rate.

2、穿刺治疗:肾囊肿穿刺作用不大,不仅易于感染,易于复发,而且经过长期观察,该术也不能延缓肾功能损坏的发生。

2, puncture for the treatment of renal cyst puncture effect is not big, not only easy to infection, easy to relapse, and through long-term observation, the patients can not slow down the occurrence of renal damage.  

3, under the guidance of ultrasound interventional therapy: to locate puncture intracapsular cyst, rinse, and then injecting sclerosing agent, about 82% of patients can achieve a cure. 98% after 1 times above cured.

4、腹腔镜微创手术:肿物较大且有恶变可能时,可以进行腹腔镜探查,如果证实为良性囊肿,可将肾表面的囊壁切除,边缘用肠线与肾实质连续缝合,残留囊壁涂以碘酊。一侧肾实质广泛破坏,对侧肾功能正常者,可行腹腔镜肾切除术。腹腔镜治疗是现今不错的微创手术方法。

4, minimally invasive laparoscopic surgery: mass is larger and malignancy, can carry out laparoscopic exploration, if confirmed as benign cyst, cystic wall surface can be removed of kidney, renal parenchyma with catgut and continuous suture edge, residual cyst wall painted with tincture of iodine. One side renal parenchymal extensively damaged, contralateral normal renal function, feasible laparoscopic nephrectomy. Laparoscopic treatment of minimally invasive surgical method is now good.      


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