后腹腔镜离断性肾盂成形术治疗UPJO的临床研究  

Clinical effect of retroperitoneal laparoscopic isolated pyeloplasty in the treatment of UPJO

作　　者：朱斌[1] 潘卫兵[1] 谢礼仁 张遂兵[1] 罗林斌 盘昌力 

机构地区：[1]深圳市坪山新区人民医院泌尿外科,广东深圳518118

出　　处：《中国城乡企业卫生》2016年第11期1-3,共3页Chinese Journal of Urban and Rural Enterprise Hygiene

摘　　要：目的观察后腹腔镜离断式肾盂成形术治疗先天性肾盂输尿管连接部梗阻(UPJO)的临床效果。方法回顾性分析深圳市坪山新区人民医院2009年1月-20 1 4年2月手术治疗的87例UPJO患者。根据手术方法不同,将患者分为观察组(后腹腔镜下离断性肾盂成形术)3 8例和对照组(Anderson-Hynes开放性离断式肾盂成形术)4 9例。观察两组手术中出血、术后并发症发生及随访24个月肾积水情况等。结果与对照组相比,观察组术中出血少,切口长度短,术后镇痛剂用量少;术后下地时间及住院时间短;术后切口感染、漏尿及腹膜后血肿发生率均低于对照组,差异有统计学意义(P<0.0 5)。两组患者术后随访24个月,肾积水发生率差异无统计学意义(P>0.0 5)。结论与传统开放式手术进行比较,后腹腔镜离断式肾盂成形术治疗UPJO创伤较小,术后并发症较少、恢复速度较快。Objective To observe the clinical effect of retroperitoneal laparoscopic of the pyeloplasty in the treatment of congenital ureteropelvic juntion obstruction（UPJO）. Methods 87 cases of children patients with UPJO accepted surgery were retrospectively analyzed in Pingshan People＇s Hospital of Shenzhen from January of 2009 to February of 2014. The patients were divided into two groups,observation group（by retroperitoneal laparoscopic isolated pyeloplasty in 38 cases） and control group（Anderson-Hynes open amputation formula pyeloplasty in 49 cases）. Bleeding during operation,postoperative incidence of complications and the situation of the kidney of 24 months followed-up n two groups were observed. Results Compared with the control group,the bleeding was less in the observation group,and the incision length was shorter,the dosage of analgesic was less,duration time after operation to ambulation and hospital stay were shorter,the incidence of postoperative wound infection,leakage of urine and retroperitoneal hematoma were lower in the observation group（P〈0.05）. There was no significant difference in the incidence of uronephrosis in the both groups after 24 months follow-up（P〉0.05）. Conclusion Retroperitoneal laparoscopic surgery in the treatment of congenital UPJO operation have been described with several advantages compared with traditional open surgery that include reduced postoperative pain,shorter convalescence and minimal disfigurement.

关 键 词：肾盂输尿管连接部梗阻 先天性 离断性肾盂成形术 腹腔镜 肾积水 

分 类 号：R69[医药卫生—泌尿科学]