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目的 :提高对肾癌下腔静脉癌栓的认识。方法 :结合文献复习对6例下腔静脉癌栓的诊断及治疗 ,进行讨论。结果 :6例经磁共振成像均确定癌栓范围 ,其中4例膈下型 ,2例为膈上型。全部手术取出癌栓 ,1例术后12天死于急性肾功能衰竭 ,1例术后16个月死于肝转移 ,其余4例目前健在 ,最长者已生存43个月。结论 :磁共振成像是术前确定癌栓范围的最好方法 ,手术方法的选择取决于癌栓伸入腔静脉的水平和是否侵犯腔静脉壁。
Objective: To improve the understanding of carcinoma thrombus of inferior vena cava in renal cell carcinoma. Methods: The literature review of the diagnosis and treatment of 6 cases of IVC tumor thrombus were discussed. Results: The scope of thrombosis was confirmed by magnetic resonance imaging in 6 cases, of which 4 cases were subphypic type and 2 cases were phrenic type. Thrombolysis was performed in all cases. One patient died of acute renal failure 12 days after operation, one died of liver metastasis 16 months after operation, and the remaining 4 patients were alive. The longest survived for 43 months. CONCLUSIONS: Magnetic resonance imaging is the best method for preoperative determination of the extent of tumor thrombus, and the choice of surgical procedure depends on whether the thrombus penetrates into the vena cava and invading the wall of the vena cava.