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作 者:谢华[1] 徐卯升[1] 耿红全[1] 李衷初[1] 刘国华[1] 陈方[1]
机构地区:[1]上海第二医科大学附属新华医院泌尿外科,上海200092
出 处:《中华小儿外科杂志》2005年第12期638-641,共4页Chinese Journal of Pediatric Surgery
摘 要:目的探讨儿童反射性无尿的诊断与治疗。方法对1995年1月~2002年12月收治的7例患儿的临床及随访资料进行回顾性分析。结果7例患儿,男5例,女2例,年龄13d^6岁,均有先天性上尿路梗阻。3例为肾盂和输尿管术后的患儿,余4例分别发生于下腹部外伤、腹泻、呕吐以及新生儿等状况下。初期1例患儿接受肾盂成形术,1例行双侧输尿管膀胱再植术;后期2例予肾造瘘,3例予输尿管逆行插管引流,肾功能均恢复。结论上尿路梗阻的患儿易发生反射性无尿,其发生与输尿管痉挛相关,行上尿路引流是简单有效的治疗方法。Objective To review the diagnosis and treatment of the children's reflex anuria. Methods Charts of 7 children's admitted between January 1995 and December 2002 were reviewed. Results Seven children (5 boys and 2girls) with age ranged between 13 days to 6 years old, all had congenital upper urinary tract obstruction. Three cases of reflex anuria occurred just after nephrectomy and pyeloplasties. The other 4 developed anuria and acute renal failure after lower abdominal trauma, diarrhea, vomiting respectively and one developed anuria during neonatal period. In the early period 1 patient underwent pyeloplasty and l patient undertook bilateral ureteric reimplantation. Later 2 children underwent nephrostomies and remaining 3 kids underwent retrograde transurethral ureteral catheterization. The renal function in every case resumed quickly with dialysis. Conclusions The children with congenital upper urinary tract obstructions are susceptible to reflex anuria. Their pathological mechanism may be related to ureteral spasm as well as intrarenal arteriolar spasm. The upper urinary tract drainage is a simple and effective therapy.
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