双侧输尿管巨大囊肿脱垂至尿道口伴急性肾功能不全1例并文献复习  

Bilateral Giant Ureteroceles Prolapsed to Urethral Orifice Accompanied with Acute Kidney Injury:A Case of and Literature Review

作　　者：陈杰勋 王恺 陈冬明 祝帅 王冬 许贤林 CHEN Jie-xun;WANG Kai;CHEN Dong-ming;ZHU Shuai;WANG Dong;XU Xian-lin(Department of Urological Surgical,Sir Run Run Hospital,Nanjing Medical University,Nanjing 210000,Jiangsu Province,China)

机构地区：[1]南京医科大学附属逸夫医院泌尿外科,江苏南京210000

出　　处：《罕少疾病杂志》2023年第1期1-3,共3页Journal of Rare and Uncommon Diseases

基　　金：南京医科大学科技发展基金项目(NMUB2019084)。

摘　　要：目的加强对输尿管囊肿不典型临床表现的认识,提高诊疗水平。方法回顾性分析1例双侧输尿管巨大囊肿患者的临床资料、治疗方案和随访结果,并结合国内外文献探讨输尿管巨大囊肿脱垂至尿道外口、导致梗阻性急性肾功能不全的发病和诊疗状况。结果患者因“尿频、尿急、尿痛4天,发现尿道外口肿物7小时”入院。患者入院后少尿、肌酐进行性升高,术前诊断为尿道旁囊肿、双肾积水、急性肾功能不全、急性肾盂肾炎,术中诊断为双侧输尿管囊肿伴双肾积水、急性肾功能不全、急性肾盂肾炎,予以等离子电切治疗,术后恢复良好,尿量、肌酐逐渐恢复正常。结论双侧输尿管囊肿中一侧输尿管囊肿脱出尿道外口,应注意与其他尿道口赘生物疾病的鉴别诊断。输尿管囊肿脱垂导致的急性肾功能不全并不常见,及时治疗、解除尿道梗阻可获得较好的疗效。Objective To extend the understanding of atypical clinical symptoms of ureterocele and improve clinical diagnosis and treatment.Methods The clinical data,treatment plan and follow-up results of current case were retrospectively analyzed.The incidence,diagnosis and treatment of obstructive acute renal injury caused by prolapsed ureteroceles were discussed with literature reports.Results The patient was admitted to the hospital due to"urinary frequency,urgency,and odynuria for 4 days with urethral orifice neoplasm for 7 hours".After admission,oliguria and creatinine increasement were aggravated.The preoperative diagnosis were paraurethral cyst,bilateral hydronephrosis,acute renal injury and acute pyelonephritis.The intraoperative diagnosis were bilateral ureteral cyst with hydronephrosis,acute renal injury and acute pyelonephritis.The patient underwent plasma-kinetic electric resection treatment and recovered well from operation,meanwhile the urine volume and creatinine gradually recovered.Conclusion Bilateral ureteroceles prolapsed to urethral orifice were rare situation which should be paid attention to the differential diagnosis from other neoplasm diseases.Acute kidney injury caused by ureteroceles were uncommon,while timely treatment could relief urethral obstruction and obtain effective treatment.

关 键 词：输尿管囊肿 尿道旁囊肿 急性肾功能不全 经尿道等离子电切术 

分 类 号：R733.2[医药卫生—肿瘤]