经腰部小切口离断式肾盂输尿管成形术治疗独肾肾盂积水  

Ureteropyeloplasty operation via lumbar micro-incision in dealing with hydronephrosis patient of solita- ry kidney

作　　者：覃道锐 刘国昌 伏雯 

机构地区：[1]广州市妇女儿童医疗中心珠江新城院区小儿泌尿外科,广东省广州市510623

出　　处：《临床小儿外科杂志》2014年第4期291-293,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的：探讨经腰部小切口离断式肾盂输尿管成形术治疗独肾肾盂积水的可行性及疗效。方法回顾性分析2010年12月至2013年2月我们收治的17例独肾肾盂积水患儿临床资料，男10例，女7例。其中16例行腰部小切口离断式肾盂输尿管成形术加肾盂造瘘术，1例行单纯经腰部小切口离断式肾盂输尿管成形术。术后逐月复查超声及尿常规，术后1年复查静脉肾盂造影了解肾积水恢复情况。均获3个月至3年随访。结果17例均手术成功，术后均逐月复查患肾超声及尿常规，无严重尿路感染，无镜下血尿等。超声检查提示肾实质均较术前增厚，集合系统分离明显减轻，3例已无积液。15例获长期随访患儿术后1年复查静脉肾盂造影，均于2 min内显影。结论独肾肾盂积水应积极处理，采取精确定位下经腰部小切口离断式肾盂输尿管成形术加肾盂造瘘术是安全有效的一种术式。Objetive To investigate the outcome and surgery treatment of hydronephrosis of solitary kid-ney patient. Methods 1 7 patients （1 0 males and 7 females）were retrospectively reviewed between October 201 0 and February 201 3,who had been diagnosed with hydronephrosis of solitary kidney and received surgical treatment.The follow-up time was 3 months to 3 years.All patients were followed up with ultrasonography and routine urine test monthly and 1 5 patients received intravenous pyelography in the first year after operation. Results All 1 7 patients received surgical intervention,except one patient who received ureteropyeloplasty oper-ation,the other 1 6 patients received ureteropyeloplasty operation and nephrostomy both.All operation went smoothly.All patient received 3months to 3 years follow-up with routine urine test and ultrasonography month-ly.No severe urinary tract infection and hematuria was noted.The thickening of renal parenchyma and relea-sing of hydronephrosis were observed in all cases by ultrosonography study,and what’s more,no hydronephro-sis were observed in 3 patients.All kidneys developed less than 2 minutes during the intravenous pyelography study in the first year after operation. Conclusion Hydronephrosis of solitary kidney patient should be treated positively and cautiously.Ureteropyeloplasty operation plus nephrostomy via lumbar micro-incision is a safe and effective choice for hydronephrosis of solitary kidney patient.

关 键 词：输尿管 肾盂积水 外科手术 微创性 

分 类 号：R726.99[医药卫生—儿科]