小儿先天性重度肾积水的外科治疗  

Surgical treatment of congenital giant hydronephrosis in children

作　　者：陶文芳[1] 李昭铸[1] 孙岩[1] 王凤兰[1] 

机构地区：[1]哈尔滨医科大学附属第二医院小儿外科,哈尔滨150086

出　　处：《临床泌尿外科杂志》2001年第5期213-214,共2页Journal of Clinical Urology

摘　　要：目的：探讨小儿先天性重度肾积水保存肾脏行肾盂输尿管成形术的指征及疗效。方法：对３２例先天性肾积水患者，术前行Ｘ线腹部平片、Ｂ超、ＩＶＵ、ＣＴ、肾图检查，术中排出积水后观察肾形态及其皮质的厚度和色泽。结果：Ｂ超及ＣＴ诊断巨大肾积水，而常规ＩＶＵ造影２８例中１４例未显影，６例肾图检查中３例呈无功能曲线。但 ３２例中 ３０例术中排出积水后．肾脏体积明显缩小，其皮质厚度大部分在０．３～０．５ ｃｍ以上，皆有一定泌尿功能。结论：小儿先天性肾积水常规ＩＶＵ检查不显影及术前肾图的无功能曲线皆不能作为肾切除的指征，应依据肾皮质之厚度、肾脏的病理改变及对侧肾功能情况选择外科手术方法。Purpose:To appraise the indication and effect of Anderson-Hynes operation in the children with congenital serious hydronephrosis. Methods: Thirty-two cases of congenital hydronephrosis were studied during past 10 years. We compared the results of X-ray .ultrasound ,IVU ,CT,and isotope imaging before operation and cortices' thickness .color and the volume of the kidney with hydronephrosis after drainage. Results : Giant serious hydronephrosis were found under the ultrasound and/or CT in all cases. Fourteen cases of 28 cases with 1VU did not develop. Three cases of 6 cases underwent isotope imaging were malfunction. During operation we found 30 cases of 32 cases were functional and the volume of the kidney decreased and cortices' thickness of the kidney were more than 0. 3-0. 5 cm. Conclusions:We should select operation method according to cortices' thickness of the kidney .pathological changes of the kidney, and the function of the contralateral kidney. It is not helpful to assess the function of the kidney with giant serious hydronephrosis when common IVU and isotope imaging is negative.

关 键 词：肾积水 肾盂输尿管连接处狭窄 儿童 外科手术 

分 类 号：R726.922[医药卫生—儿科]