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中华腔镜泌尿外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (06) : 784 -791. doi: 10.3877/cma.j.issn.1674-3253.2025.06.016

综述

胡桃夹综合征诊治进展
许梓锋, 黄展森, 狄金明†()   
  1. 510630　广州，中山大学附属第三医院泌尿外科
  • 收稿日期:2025-02-10 出版日期:2025-12-01
  • 通信作者: 狄金明
  • 基金资助:
    国家自然科学基金面上项目(82272840); 广东省自然科学基金(2021A1515010129)

Progress in diagnosis and treatment of nutcracker syndrome

Zifeng Xu, Zhansen Huang, Jinming Di†()   

  1. Department of Urology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China
  • Received:2025-02-10 Published:2025-12-01
  • Corresponding author: Jinming Di
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引用本文：

许梓锋, 黄展森, 狄金明. 胡桃夹综合征诊治进展[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2025, 19(06): 784-791.

Zifeng Xu, Zhansen Huang, Jinming Di. Progress in diagnosis and treatment of nutcracker syndrome[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2025, 19(06): 784-791.

胡桃夹综合征（NCS）是一种因左肾静脉受到腹主动脉与肠系膜上动脉或脊柱夹角压迫所引起的多样化症状的综合征，其临床表现各异，且缺乏特异性。尽管对胡桃夹综合征的诊疗水平不断提高，但目前对其的诊断标准、治疗方式及手术适应证等方面均尚存在争议。本文论述了胡桃夹综合征近年来诊断与治疗等方面的现状和进展，并指出手术技术的发展为NCS患者提供了更多的治疗选择，为临床工作者提供参考。

关键词: 胡桃夹综合征, 左肾静脉狭窄, 血管内治疗, 微创手术, 精准诊断

Nutcracker Syndrome (NCS) is a condition characterized by a variety of symptoms caused by the compression of the left renal vein by the angle between the abdominal aorta and the superior mesenteric artery or the spine. The clinical manifestations of NCS are diverse and lack specificity. Although advancements in the diagnosis and treatment of NCS, controversies remain regarding its diagnostic criteria, treatment approaches, and surgical indications. This article reviews recent progress in the diagnosis and treatment of NCS, highlights the role of advances in surgical techniques in providing more treatment options for patients, and serves as a reference for clinicians.

Key words: Nutcracker syndrome, Left renal vein stenosis, Endovascular procedures, Minimally invasive surgical procedures, Precision diagnosis
图1 胡桃夹综合征（NCS）的解剖分型示意图注：a为前胡桃夹综合征；b为后胡桃夹综合征；c为前胡桃夹并后胡桃夹综合征；LRV为左肾静脉；AA为腹主动脉；SMA为肠系膜上动脉；IVC为下腔静脉
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