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目的:分析对腹膜后纤维化(RPF)的诊断、治疗状况,提高RPF的早期诊断率。方法:总结5例RPF患者的诊断、治疗和预后情况。结果:5例患者的初发症状各异,但腰背痛、腹痛为多见,后期症状因受累脏器的不同而异,其中以腹部包块、腹腔积液、泌尿系统症状及肠梗阻常见。CT和磁共振成像表现为主要诊断依据,但B超检查有利于合并肾积水及输尿管病变患者的诊断。当疾病在活动期,应积极给予足量激素和免疫抑制剂治疗;当纤维化已形成并发展到梗阻时,需及时手术治疗。结论:腹膜后纤维化发病率低,误诊率高。糖皮质激素对该病效果比较好,后期常需要手术治疗。
Objective: To analyze the diagnosis and treatment of retroperitoneal fibrosis (RPF) and to improve the early diagnosis rate of RPF. Methods: To summarize the diagnosis, treatment and prognosis of 5 patients with RPF. Results: Five patients had different initial symptoms, but low back pain and abdominal pain were more common. Later symptoms were different according to the organs involved. Among them, abdominal mass, ascites, urinary symptoms and intestinal obstruction were common . CT and magnetic resonance imaging showed the main basis for diagnosis, but B-ultrasound is conducive to the diagnosis of patients with hydronephrosis and ureteral lesions. When the disease is active, adequate hormone and immunosuppressive therapy should be given actively; when fibrosis has developed and progressed to obstruction, timely surgical treatment is required. Conclusion: The incidence of retroperitoneal fibrosis is low and the rate of misdiagnosis is high. Glucocorticoids effect of the disease is better, the latter often require surgical treatment.