上半肾功能较差的重复肾伴完全性重复输尿管治疗术式的研究进展  

Research advances of surgery for duplex kidney with complete duplex ureter with poor upper renal function

作　　者：刘赛赛 郭云飞[1] 黄立渠 Liu Saisai;Guo Yunfei;Huang Liqu(Jiangsu Children's Medical Center,Affiliated Children's Hospital,Nanjing Medical University,Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]江苏省儿童医学中心,南京医科大学附属儿童医院泌尿外科,南京210008

出　　处：《中华小儿外科杂志》2022年第12期1143-1149,共7页Chinese Journal of Pediatric Surgery

基　　金：国家自然科学基金(82000643);江苏省自然科学基金青年项目(BK20200152)。

摘　　要：重复肾伴重复输尿管是小儿泌尿系统常见疾病。根据输尿管数目分类,可分为重复肾伴不完全性重复输尿管和重复肾伴完全性重复输尿管。通常上半肾分肾功能差异较大,对于重复肾的治疗目前仍存在一些争议,尤其是在上半肾功能较差(<10%)且伴有肾积水、输尿管严重扩张的完全性重复肾的治疗方面,是否行保留肾单位的手术主要依靠经验,目前仍缺乏客观标准来决定上半肾的切除或保留。对上半肾功能较差且肾皮质较薄的重复肾的治疗,既往多数医生会选择行上半肾切除术,近年来输尿管端侧吻合术在临床中的应用逐渐增多。现对上半肾功能较差的完全性重复肾两种常见的手术治疗方式及其预后做一综述,比较不同治疗术式的差异,为临床诊疗提供参考。Duplex kidney and ureter is a common disease of urinary system in children.Based upon a count of ureters,it can be divided into duplex kidney with incomplete ureteric duplication of ureter and duplex kidney with complete ureteric duplication.Usually greater differences exist in renal function in upper part of kidney.Currently some disputes persist in a proper treatment of duplex kidney.Especially,managing complete duplex kidney with poor upper renal function(<10%)and hydronephrosis and severe ureteral dilatation is more controversial.Retaining nephron or not relies mainly on operative experience.There is still a lack of objective criteria for determining upper renal resection or preserving.For duplex kidney with poor upper renal function and thin renal cortex,most surgeons prefer upper pole heminephrectomy(UHN).Ureteroureterostomy(UU)has been applied in clinical practices.This review summarized the approaches and outcomes of two most common surgical options for complete repeat kidney with poor upper renal function.And the differences of various surgical approaches are compared to provide references for clinical decision-making.

关 键 词：肾 重复肾 肾部分切除术 儿童 预后 

分 类 号：R726.9[医药卫生—儿科]