经脐三通道腹腔镜肾盂成形术治疗小儿肾积水疗效观察及对肾功能影响  

Observation of Curative Effect of Transumbilical Three-channel Laparoscopic Pyeloplasty for Children with Hydronephrosis and Its Effect on Renal Function

作　　者：余世万 杨军[1] 孙凯 张龙 魏延青 向远超 刘娟[1] Yu Shiwan;Yang Jun;Sun Kai;Zhang Long;Wei Yanqing;Xiang Yuanchao;Liu Juan(Department of Pediatric Surgery,Nanyang No.2 People's Hospital,Nanyang 473000)

机构地区：[1]南阳市第二人民医院小儿外科,南阳473000

出　　处：《数理医药学杂志》2021年第6期805-807,共3页Journal of Mathematical Medicine

基　　金：河南省医学科技攻关计划(编号:2018020988)。

摘　　要：目的:分析经脐三通道腹腔镜肾盂成形术治疗小儿肾积水的手术效果及对肾功能的影响。方法:收集135例单侧肾积水患儿临床资料,根据手术方式分为观察组72例和对照组63例,观察组给予经脐三通道腹腔镜肾盂成形术,对照组给予经脐单通道腹腔镜肾盂成形术,比较两组手术效果、肾功能相关指标。结果:观察组肾积水小儿术中出血量明显低于对照组,引流管留置时间、住院时间明显短于对照组[(7.12±1.05 vs 8.32±1.10)ml、(2.65±0.34 vs 3.12±0.45)d、(7.86±1.12 vs 8.54±1.01)d](t=6.479,6.895,3.634,P<0.05);随访12个月,观察组患者肾盂前后径、尿素氮(BUN)、肌酐(Cr)明显低于对照组,肾小球滤过率(FGF)明显高于对照组[(1.42±0.26 vs 1.65±0.30)cm、(10.24±1.45 vs 15.32±2.24)mmol/L、(118.32±13.24 vs 135.45±12.36)μmol/L、(44.52±3.65 vs 41.25±4.16)ml/min](t=4.772,15.827,7.345,4.865,P<0.05,P<0.01)。结论:经脐三通道腹腔镜肾盂成形术有助于减轻手术创伤,促进肾积水小儿术后肾功能恢复。Objective:To analyze the effect of transumbilical three-channel laparoscopic pyeloplasty on children with hydronephrosis and its effect on renal function.Methods:The clinical data of 135 children with unilateral hydronephrosis were collected.According to the operation methods,72 cases were divided into the observation group and 63 cases were divided into the control group.The observation group was treated with transumbilical three-channel laparoscopic pyeloplasty,while the control group was treated with transumbilical single-channel laparoscopic pyeloplasty.The operative effect and renal function were compared between the two groups.Results:The amount of intraoperative bleeding in children with hydronephrosis in the observation group was significantly lower than that in the control group,and the duration of indwelling drainage tube and hospitalization in the observation group were significantly shorter than those in the control group[(7.12±1.05 vs 8.32±1.10)ml,(2.65±0.34 vs 3.12±0.45)d,(7.86±1.12 vs 8.54±1.01)d](t=6.479,6.895,3.634,P<0.05).After 12 months of follow-up,the renal pelvis anterior and posterior diameter,urea nitrogen(BUN)and creatinine(Cr)in the observation group were significantly lower than those in the control group,and the glomerular filtration rate(FGF)was significantly higher than that in the control group[(1.42±0.26 vs 1.65±0.30)cm,(10.24±1.45 vs 15.32±2.24)mmol/L,(118.32±13.24 vs 135.45±12.36)μmol/L,(44.52±3.65 vs 41.25±4.16)ml/min](t=4.772,15.827,7.345,4.865,P<0.05,P<0.01).Conclusion:Transumbilical three-channel laparoscopic pyeloplasty is helpful to reduce surgical trauma and promote the recovery of renal function in children with hydronephrosis.

关 键 词：肾积水 小儿 经脐三通道腹胀镜 肾盂成形术 肾功能 

分 类 号：R726.9[医药卫生—儿科]