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分析 36例肾血管平滑肌脂肪瘤 (RAML)的临床资料 :行IVP检查 36例 ,B超检查 35例 ,CT扫描 30例 ,MRI检查 11例 ,肾动脉造影 (DSA) 2例。手术治疗 32例 ,其中肾切除 2 0例 ,部分切除或瘤体剜除 6例 ,术前误诊断的 6例中 ,3例行肾根治切除术 ,3例因自发性肾破裂切除患肾。术中全部快速冷冻切片病理检查 ,诊断为RAML ,无一例恶变。术后随访 1～ 5年无复发。非手术治疗 4例随访观察。B超、IVP是RAML常用初步诊断方法 ,CT结合MRI是最好的影像学诊断方法 ,能提高术前诊断率。对肿瘤直径 >3cm且逐渐增大或肿瘤直径 <3cm伴明显症状者 ,应积极行手术治疗 ,尽量保留有功能的肾组织。
The clinical data of 36 patients with renal angiomyolipoma (RAML) were analyzed. 36 patients underwent IVP, 35 underwent B ultrasound, 30 underwent CT scan, 11 under MRI and 2 underwent DSA. Surgical treatment of 32 cases, including 20 cases of nephrectomy, partial resection or tumor removal in 6 cases, preoperative misdiagnosis of 6 cases, 3 cases of radical nephrectomy, 3 cases of spontaneous rupture of the kidneys. Intraoperative rapid frozen section biopsy, diagnosed as RAML, no case of malignant transformation. Follow-up 1 to 5 years without recurrence. Non-surgical treatment of 4 cases were followed up. B ultrasound, IVP RAML common initial diagnostic method, CT combined with MRI is the best imaging diagnostic method, can improve the preoperative diagnosis rate. On the tumor diameter> 3cm and gradually increased or tumor diameter <3cm with obvious symptoms should be actively treated by surgery, try to retain the function of renal tissue.