先天性马蹄肾及其合并症的诊治分析  

The Diagnosis and Treatment of Congenital Horseshoe Kidney and Complications

作　　者：季辉华[1] 李云飞[1] 张少峰[1] 

机构地区：[1]湖北医药学院附属人民医院泌尿外科,湖北士堰442000

出　　处：《医学综述》2011年第3期479-480,共2页Medical Recapitulate

摘　　要：目的探讨先天性马蹄肾及其合并症的临床特点与诊治方法。方法回顾分析10例马蹄肾的临床资料。结果 10例患者中合并肾积水10例,合并结石5例,合并泌尿系感染1例。手术病例术前均行静脉肾盂造影和CT。5例行峡部分离+肾盂成形术(Anderson-Hynes术式),术后肾积水减轻,症状消失。2例行峡部分离一侧无功能肾切除术,术后对侧肾代偿性轻度积水。2例行经皮肾穿刺微造瘘输尿管镜碎石取石术,总的结石清除率100%。1例行抗感染治疗。结论马蹄肾的诊断主要依靠静脉肾盂造影和CT,马蹄肾的治疗在于合并症的治疗,手术主要是峡部分离和处理合并症。Objective To examine the clinical characteristics,and diagnostic and therapeutic approaches for congenital horseshoe kidney and complications.Methods The clinical data of horseshoe kidney patients（n=10）were retrospectively analyzed.Results Out of ten patients with horseshoe kidney,ten were complicated with nephrohydrosis,five with calculi,and one with urinary tract infection.Prior to the surgery,all the ten patients received intravenous pyelography and CT scan.Five patients underwent Anderson-Hynes′ procedure,resulting in the alleviation of nephrohydrosis and the absence of symptoms.Two patients received the strictureplasty and the resection of ipsilateral non-functional kidney,in whom the contralateral kidneys exhibited mild compensatory nephrohydrosis postoperatively.Two patients received percutaneous pelviostomy and ureteroscopic lithotomy.The overall removal rate of calculi was 100%.One patient received antibiotics.Conclusion The diagnosis of horseshoe kidney depends mainly on intravenous pyelography and CT scan.The treatment for horseshoe kidney targets at complications.Surgical interventions are used to dilate the stricture and resolve complications.

关 键 词：马蹄肾 合并症 诊治 

分 类 号：R692.13[医药卫生—泌尿科学]