Xanthogranulomatous pyelonephritis: clinical experience with 21 cases
Xanthogranulomatous pyelonephritis: clinical experience with 21 cases
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DOI：
10.1007/s10156-013-0611-z
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发表时间：
2013-12-01
影响因子：
2.2
通讯作者：
Cho, Yong-Hyun
中科院分区：
文献类型：
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作者：
Kim, Sun Wook;Yoon, Byung Il;Cho, Yong-Hyun
在本回顾性研究中，我们回顾了21例最近的黄色肉芽肿性肾盂肾炎（XGP）的特征，并与目前已发表的报告进行了比较，以提高术前诊断。回顾性分析21例XGP患者的临床、实验室、影像学特点、术前诊断及手术方法。患者平均年龄52.1岁；男女比例为2.5:1。所有患者均有症状，最常见的症状是腹部疼痛和发热超过38℃。实验室结果显示贫血71.4%，白细胞增多61.9%，脓尿81.0%。影像学检查发现肾结石或输尿管结石9例，肾积水12例，肾肿块2例，肾肿大9例。术前怀疑有XGP的患者行部分肾切除术；2例疑似肾细胞癌行根治性肾切除术；其余18例患者行单纯肾切除术。在主诉腹痛发热的患者中，如果患者有尿路感染，有贫血或白细胞增多的征象，放射检查有鹿角状结石或尿路梗阻、肾包块，则认为应考虑XGP的可能性。
In this retrospective study, a review of the features of 21 recent cases of xanthogranulomatous pyelonephritis (XGP) is presented and compared with current published reports to improve the preoperative diagnosis. The clinical, laboratory, and radiological features, preoperative diagnoses, and operative methods of 21 patients with XGP were retrospectively reviewed. Mean age of the patients was 52.1 years; the female:male ratio was 2.5:1. All patients were symptomatic, and most common symptoms were flank pain and fever greater than 38A degrees C. The laboratory results showed anemia in 71.4 % of cases, leukocytosis in 61.9 %, and pyuria in 81.0 %. In radiologic examinations, renal or ureter stone in 9 patients, hydronephrosis in 12 patients, a renal mass in 2 patients, and kidney enlargement in 9 patients were observed. For the patient who was suspected as having XGP before surgery, partial nephrectomy was performed; for 2 patients who were suspected as renal cell carcinoma, radical nephrectomy was performed; and for the remaining 18 patients, simple nephrectomy was performed. Among patients complaining of flank pain and fever, if the patients have a urinary tract infection and show the signs of anemia or leukocytosis and have staghorn calculi or a urinary tract obstruction and renal mass by radioactive examination, it is believed that the possibility of XGP should be considered.