球囊扩张术治疗原发性梗阻型巨输尿管的可行性研究  

Feasibility analysis of balloon dilatation for primary obstructive megaureter

作　　者：钟量[1] 邹翔宇 孙杰[1] Zhong Liang;Zou Xiangyu;Sun Jie(Department of Urology,Shanghai Children's Medical Center,Shanghai Jiao Tong University,School of Medicine,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心泌尿外科,上海200127

出　　处：《临床小儿外科杂志》2023年第2期139-143,共5页Journal of Clinical Pediatric Surgery

基　　金：市级医院诊疗技术推广及优化管理项目(SHDC220222306)

摘　　要：目的总结采用球囊扩张术治疗的原发性梗阻型巨输尿管患儿资料,探讨该治疗方法的安全性及可行性。方法回顾性收集2018年9月至2022年1月在上海交通大学医学院附属上海儿童医学中心泌尿外科行球囊扩张术治疗的原发性梗阻型巨输尿管患儿术前及术后随访资料,包括年龄、性别、肾盂前后径、输尿管最宽径、分肾功能等数据。采取自身前后对照的方法对疗效进行分析。结果本院共收治41例原发性梗阻型巨输尿管患儿,共42侧输尿管实施球囊扩张术。2例拔除DJ管后仍有反复腹痛,改行输尿管再植术治愈;1例球囊扩张失败,术后未予进一步治疗,随访至今已33个月,肾积水症状无缓解;1例行扩张术中输尿管破裂,经输尿管再植术治愈。其余37例(38侧输尿管)均手术成功并获随访,患儿年龄(32.9±35.7)个月,随访时间(17.2±9.5)个月,术前分肾功能(48%±10%);肾盂前后径术前为(17.8±14.7)mm,术后为(9.7±8.9)mm,差异有统计学意义(P<0.01);输尿管最宽径术前为(13.4±2.9)mm,术后为(7.5±6.9)mm,差异有统计学意义(P<0.01)。结论采用球囊扩张术治疗原发性梗阻型巨输尿管,短期随访上尿路积水症状明显改善。球囊扩张术操作简单,术后恢复快,具有广阔的应用前景。Objective To retrospectively review the postoperative follow-up data of balloon dilation for primary obstructive megaureter and explore its safety and feasibility.Methods From September 2018 to January 2022,preoperative and postoperative follow-up data were collected.The efficacy was statistically analyzed by compared the preoperative and postoperative data.Results 41 children with primary obstructive megaureter(42 ureters)undergoing balloon dilation,two cases of abdominal pain underwent laparoscopic ureteral reimplantation.One child failed to dilate,hydronephrosis remained stable and there was no further treatment.Another dilated case developed ureteral rupture and underwent ureteric reimplantation.A total of 37 children(38 ureters)were successfully operated.During regular follow-ups of(17.2±9.5)months,the mean age was(32.9±35.7)months and the mean preoperative renal function(48%±10%).Anteroposterior diameter(APD)of renal pelvis was(17.8±14.7)mm pre-operation and(9.7±8.9)mm post-operation(P<0.01).And the widest diameter of ureter was(13.4±2.9)mm pre-operation and(7.5±6.9)mm post-operation(P<0.01).Conclusion Short-term follow-ups after balloon dilatation show that upper urinary tract hydronephrosis is markedly relieved as compared with preoperatively.Balloon dilatation is a simple operation with a rapid recovery and broad application prospects.

关 键 词：输尿管梗阻 扩张术 治疗结果 可行性研究 

分 类 号：R726.9[医药卫生—儿科]