上位肾分肾功能<10%重复肾患者保留或不保留上肾手术的预后比较-单中心回顾性队列研究  

Evaluating the outcomes of differential surgical management of non-functioning upper pole renal moieties in duplex collecting systems:a single-center retrospective cohort study

作　　者：殷晓鸣[1] 许卓凡 杨屹[1] Yin Xiaoming;Xu Zhuofan;Yang Yi(Department of Pediatric Urology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院小儿泌尿外科,辽宁省沈阳市110004

出　　处：《临床小儿外科杂志》2021年第4期325-329,共5页Journal of Clinical Pediatric Surgery

基　　金：2020年辽宁省重点研发计划联合计划项目(编号:2020JH 2/10300145)。

摘　　要：目的比较上位肾分肾功能<10%的重复肾患者行保留或不保留上肾单位手术的预后情况。方法回顾性分析中国医科大学附属盛京医院2008年1月至2017年6月收治的49例上位肾分肾功能<10%的重复肾畸形患者临床资料,依据不同治疗方案分为保留上肾单位组(n=22)和不保留上肾单位组(n=27),对两组术后并发症发生率和再手术率进行统计学分析。结果与不保留上肾单位组相比,保留上肾单位组术后并发症发生率(22.7%vs.3.7%)和再手术率(9.1%vs.0.0%)更高,但差异无统计学意义(P>0.05)。与不保留上肾单位组相比,保留上肾单位组患者中位手术年龄更小(16.5个月vs.33.0个月),差异有统计学意义(P=0.006)。而两组间性别、侧别、术前是否存在输尿管末端膨出/异位、术前上位肾分肾功能和术前患侧上肾输尿管直径差异均无统计学意义(P>0.05)。结论上位肾分肾功能<10%重复肾患者如需手术治疗,初次手术方式可根据医生和患者家长意愿,选择较为简单的手术方式。Objective To evaluate the outcomes of differential surgical management of non-functioning upper pole renal moieties in duplex collecting systems.Methods From January 2008 to June 2017,retrospective analysis was performed for 49 children with duplicate kidney malformation and upper renal function<10%.According to whether nephron-sparing surgery was performed,their complications and reoperative rates were compared.Results No significant difference existed in complication or reoperative rate between upper pole preservation and heminephrectomy groups(22.7%vs.3.7%,P=0.114;9.1%vs.0.0%,P=0.196).Compared with upper pole heminephrectomy group,the median operative age was younger in upper pole preservation group(16.5 vs.33.0 months,P=0.006).No significant inter-group difference existed in gender,sideness,whether associated with ureterocele/ectopic ureter,preoperative renal function or preoperative ureteral diameter.Conclusion If upper pole function is less than 10%,operation may be.performed according to the preferences of urologists and parents.

关 键 词：重复肾 肾功能不全 外科手术 治疗结果 队列研究 

分 类 号：R726.9[医药卫生—儿科] R692.2[医药卫生—临床医学]