伴肾破裂的小儿先天性肾积水诊治体会(附15例报道)  

Diagnosis and treatment of congenital hydronephrosis in children with renal rupture:15 cases reports

作　　者：王军[1] 张亚伟 郭晖[1] 雷伟 李刚 李爽[1] WANG Jun;ZHANG Yawei;GUO Hui(Department of Urological Surgery,Wuhan Children's Hospital,Tongji Medical College,Huazhong University of Science&Technology,Wuhan 430016,China)

机构地区：[1]华中科技大学同济医学院附属武汉儿童医院泌尿外科,430016

出　　处：《临床外科杂志》2020年第9期885-887,共3页Journal of Clinical Surgery

摘　　要：目的总结合并肾破裂的小儿先天性肾积水的诊断及治疗经验。方法 2016年1月~2020年1月间收治的并发肾破裂的先天性肾积水患儿15例,均急诊行手术治疗,其中6例行分期手术(即先行破裂肾修补,再择期行离断式肾盂输尿管成形术),9例行同期手术(即破裂肾修补与离断式肾盂输尿管成形术同时进行)。结果经术后6个月~4年随访,15例患儿均达到临床治愈标准,术后B超及静脉尿路造影检查提示患侧肾盂积水明显好转,患侧肾盂输尿管连接部通畅,无肾周尿囊及患肾萎缩等并发症发生。结论对外伤后突发腰腹疼痛的患儿,甚至有腹腔积液的患儿,一定要考虑有先天性肾积水合并肾破裂发生可能性;泌尿系统彩超和CT检查是确诊的重要依据;同期手术治疗部分伴肾破裂的小儿先天性肾积水安全、经济。Objective To investigate the diagnosis and treatment of congenital hydronephrotic kidney with traumatic rupture.Methods From Jan 2016 to Jan 2020,retrospective study was taken on 15 cases of congenital hydronephrotic kidney with traumatic rupture.15 cases were treated with emergency operation,6 cases underwent staging surgery and 9 cases underwent homochronous operation.Results 15 cases with congenital hydroncele recovered well and there was no case with any complication,such as allantois.Conclusions Children with sudden onset of flank pain or abdominal cavity effusion after trauma,must be considered to have the possibility of congenital hydronephrotic kidney with traumatic rupture.Urinary color to exceed and CT examination provide vital evidence for being diagnosed;Surgical treatments are the important methods for children with traumatic rupture of congenital hydronephrosis kidney.

关 键 词：肾积水 先天性 肾外伤 小儿 手术治疗 

分 类 号：R726.9[医药卫生—儿科]