首发症状为肾绞痛的主动脉夹层动脉瘤的临床诊治

• 作 者: 张义静 魏晋 孙方浩 高超 曹希亮
• 机 构: 徐州医科大学附属市立医院泌尿外科,江苏 徐州 221000;徐州医科大学附属市立医院泌尿外科,江苏 徐州 221000;徐州医科大学附属市立医院泌尿外科,江苏 徐州 221000;徐州医科大学附属市立
• 出 处: 健康必读
• 发表日期: 2022年3期
• 关键词: renal colic aortic dissecting aneurysm CT pyelosinus backflow

目的:探讨首发症状为肾绞痛的主动脉夹层动脉瘤的临床诊断方法及处理措施,以及分析临床病情,以减少误诊率,提高治愈率.方法:回顾性分析2例首发症状表现为肾绞痛的主动脉夹层动脉瘤患者的临床资料,并结合文献分析发病机理、影像学表现及治疗原则.结果:两例均为男性,年龄为57、70岁,首发症状表现为腰腹部疼痛不适,予解痉治疗无效.予以完善CT检查,明确为主动脉夹层动脉瘤.两例均手术治疗,治疗后疼痛消失.其中第二例患者术前检查考虑为输尿管瘘可能,术后予以行输尿管镜检,未见明显输尿管瘘口,予以留置DJ管.查阅文献结合CT“,”Objective: To investigate the clinical manifestations, diagnosis and treatment of aortic dissecting aneurysm, first symptom as renal colic, and considertation of the clinical conditions. So as to reduce the misdiagnosis rate and enhance the cure rate. Method: The clincial data of two cases of aortic dissecting aneurysm with first symptom as renal colic were reviewed retrospectively. Referring to literatures, we analysed the etiology, imaging examination and the treatment of aortic dissecting aneurysm with first symptom as renal colic. Result: There were a 57-year-old male and a 70-year-old male in this study. Both were diagnosed by CT, and were treatment with surgery. The second patient was considered to be ureteral fistula in preoperative examination, and underwent ureteroscopy postoperatively. No obvious ureteral fistula was observed, and the DJ tube was retained. The symptoms of renal colic disappeared. Combined with literature, it was considered as pyelosinus backflow. Conclusion: Aortic dissection aneurysms may present as renal colic, and the possibility of aortic dissection should be considered clinically in who were over 50years old. CT should be improved, and CT enhancement should be improved when necessary, so as to make the diagnosis clear, which has bought time and improved the cure rate. Andit is necessary to strengthen the understanding of renal pyelosinus backflow in clinical work to better guide clinical work and promote the recovery of patients.