双输尿管畸形并发结石的诊治体会  

Experience on the diagnosis and treatment of duplex kidney ureter deformity combined with ureteral calculi.

作　　者：覃庆平[1] 王伟[1] 李刚[1] 刘杰[1] 周毅[1] 杨剑文[1] 姚远[1] 卢启海[1] 

机构地区：[1]柳州市人民医院泌尿外科,广西柳州545006

出　　处：《海南医学》2013年第17期2589-2591,共3页Hainan Medical Journal

摘　　要：目的探讨双输尿管畸形并发结石的诊断及微创治疗方法。方法回顾性分析9例重复肾双输尿管畸形并发结石患者的临床资料。结果 B超检查9例,其中6例确诊,2例漏诊,1例误诊。KUB+IVP检查9例,7例确诊,1例提示肾上极占位病变,1例漏诊。MRU检查6例,4例确诊,2例漏诊。多层螺旋CT(MSCT)检查6例,全部确诊。所有病例均经微创方式治疗成功,无严重并发症。1例伴输尿管口囊肿者结石复发,予行输尿管镜碎石术,同时行经尿道输尿管口囊肿电切术,随访至今未见结石复发。结论 MSCT对重复肾输尿管畸形(尤其合并结石者)的诊断有重要意义。应视患肾功能、输尿管畸形的解剖位置以及结石情况制定个体化治疗方案。原则上首选ESWL、URL、mPCNL及RLU等微创技术处理结石,同时治疗重复肾本身合并的畸形,以避免结石复发。Objective To investigate the diagnosis and minimally invasive treatment of duplex kidney ureter deformity combined with ureteral calculi. Methods The clinical data of 9 patients with duplex kidney ureter deformi- ty combined with ureteral calculi were analyzed retrospectively. Results The 9 patients were examined with B ultra- sound, of which 6 were diagnosed correctively, 2 missed diagnosis, and 1 was misdiagnosed. The 9 patients were ex- amined with KUB＋IVP, of which 7 were diagnosed correctively, 1 missed diagnosis, and 1 was upper pole of kidney lesions. Six patients were examined with MRU, of which 4 were diagnosed correctively and 2 missed diagnosis. Six patients were examined with MSCT, and all the patients were diagnosed correctively. All the patients were performed successfully by minimally invasive treatment modalities, with no severe complications. One patient with ureterocele relapse calculus was treated by ureteroscopic lithotripsy and transurethral resection in therapy of ureterocele at the same time, with no recurrence of calculus. Conclusion MSCT has great value in the diagnosis of duplex kidney ure- ter deformity, especially, in combination with ureteral calculi. Individualized treatment should be managed in view of the function of kidney, the kind of deformity, anatomical position and the status of calculus. ESWL, URL, mPCNL and RLU can be selected to treat calculus first, and the malformations of duplex kidney ureter deformity itself should be managed at the same time to avoid recurrence of calculus.

关 键 词：双输尿管畸形 输尿管结石 多层螺旋CT 微创治疗 

分 类 号：R693.1[医药卫生—泌尿科学]