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目的探讨左肾静脉压迫综合征的临床特点及其诊断、治疗方法。方法回顾性分析3例男性左肾静脉压迫综合征患者的临床资料。临床表现主要为反复发作肉眼血尿,1例合并左侧精索静脉曲张。膀胱镜下均可发现左侧输尿管口喷血尿,B超及CT三维重建示腹主动脉与肠系膜上动脉夹角处左肾静脉明显受压,肾静脉近端扩张。3例均行左肾静脉下移与下腔静脉端侧吻合术。结果3例患者术前均明确诊断。术后血尿消失,痊愈出院。术后5个月及8个月复查B超、CT三维血管重建,3例患者肾脏大小均正常,左肾静脉通畅,受压现象消失,尿常规正常。结论左肾静脉压迫综合征临床特点为肾静脉高压,反复发作肉眼血尿或镜下血尿。左肾静脉下移与下腔静脉端侧吻合术是治疗该病的有效方法。
Objective To investigate the clinical features of left renal vein compression syndrome and its diagnosis and treatment. Methods The clinical data of 3 patients with left renal vein compression syndrome were retrospectively analyzed. The main clinical manifestations of recurrent gross hematuria, 1 patients with left varicocele. Cystoscopy can be found on the left ureteral orifice spleensing urine, B ultrasound and CT three-dimensional reconstruction showed the abdominal aorta and superior mesenteric artery at the left renal vein significantly pressure, proximal renal vein dilatation. Three patients underwent left renal vein and inferior vena cava anastomosis. Results 3 patients were diagnosed before surgery. Hematuria disappeared, healed and discharged. Five months and 8 months after operation, B-scan and CT three-dimensional reconstruction were performed. The size of the kidney in all 3 patients was normal, the left renal vein was unobstructed, the compression phenomenon disappeared and the urine was normal. Conclusion The clinical features of left renal vein compression syndrome are renal venous hypertension, recurring gross hematuria or microscopic hematuria. Left renal vein down with the inferior vena cava anastomosis is an effective method of treatment of the disease.