简介:摘要目的探讨肾结石合并肾癌的诊断及治疗方式.方法本院于2005年6月至2013年11月接收15例肾结石合并肾癌患者.利用回顾性分析方法,对15例患者病历资料进行详细分析.在手术前,所有患者都经过B超,CT,MRI等临床检查.根据病人的实际情况,分别采取肾切除、肾癌根治术、肾部分切除等方法.结果经CT检查的患者有11人,其术前怀疑中术前怀疑肾结石合并肾癌2例,经MRI检查的患者有4例,术前怀疑肾结石合并肾癌1例.手术后确诊15例患者,10例为透明细胞癌,2例为乳头细胞癌,良性肿瘤3例.对所有患者进行随访2年,发现2例肾结石合并透明细胞癌死亡,生存年限为别为9月、11月,其余13例患者手术后暂无复发转移.结论临床中,肾结石合并肾癌诊断率非常低,预后欠佳.在诊断疾病时,应该综合考虑结石病程、是否合并感染等情况,再结合CT、MRI等检查方法,以提高疾病诊断水平.对于手术前怀疑患有肾结石合并肾癌的患者,建议实施开放手术.关键词肾结石、肾癌、外科手术AbstractobjectiveToimprovetheclinicalsignificancefordiagnosisandoperationofrenalcalculicomplicatedwithrenalcellcarcinoma.MethodsOurhosGpitalfrom2005Juneto2013November15casesofpatientsreceivingrenalcalculicomplicatedwithrenalcellcarcinoma.ByusingtheretrospectiveanalysismethGod,adetailedanalysisof15casesofpatient'smedicalrecords.Beforetheoperation,allthepatientshavebeenBultrasound,CT,MRIandclinicalexamination.AcGcordingtotheactualconditionofpatients,respectivelytakenephrectomy,radicalnephrectomy,renalresectionmethod.ResultsAfterCTexaminationof11paGtients,including2casesofrenalcalculuswithrenalcellcarcinoma,theMRItestinpatientswith4cases,including1casesofrenalcalculiassociatedwithrenalcellcarcinoma.15patientswerefoundafteroperation,10caseswerediagnosedasclearcellcarcinoma,2caseswerediagnosedaspapillarycarcinoma,3casesofbenigntumor.Allpatientswerefollowedfor1years,found2casesofrenalcalculuswithdeathclearcellcarcinoma,survivalperiodinSeptemberNovember,don't,norecurrenceandmetastasis13casesunderwentoperationafterthe.ConclusionTheclinicaldiagnosisofrenalcellcarcinoma,renalcalculuswithverylowefGficiency,poorprognosis.Inthediagnosisofdisease,shouldbeintegratedintostonecourse,infectionandsoon,combinedwithCT,MRIandotherexaminationmethods,toimprovethediagnosticlevel.Fortheoperationofundiagnosedwassuspectedofsufferingfromkidneystonesandrenalcellcarcinomapatients,shouldbetheKiemyplweomrdesntationofopenoperation,nottreatedbyPCNL.kidneystones,renalcellcarcinoma,surgicaloperation中图分类号R692.4文献标识码B文章编号1008-6315(2015)12-1308-02