腹腔镜肾积水肾盂输尿管成形术治疗肾盂输尿管连接部梗阻合并肾积水的近期疗效观察  

Short-term and Long-term Effect of Laparoscopic Dismembered Pyeloplasty in the Treatment of Ureteropelvic Junction Obstruction with Hydronephrosis

作　　者：陈梦 陈小雪 杨帆[1] Chen Meng;Chen Xiaoxue;Yang Fan(The First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 45000)

机构地区：[1]郑州大学第一附属医院,河南郑州450000

出　　处：《辽宁医学杂志》2023年第6期69-72,共4页Medical Journal of Liaoning

摘　　要：目的分析腹腔镜肾积水肾盂输尿管成形术治疗肾盂输尿管连接部梗阻合并肾积水的近期疗效。方法选择2016年12月~2019年12月收诊的肾盂输尿管连接部梗阻合并肾积水患者80例,采用随机数字法分成对照组与观察组,每组40例。对照组患者接受开放性手术治疗,观察组患者接受腹腔镜肾积水肾盂输尿管成形术治疗。比较两组患者一般指标、并发症,分析近远期疗效情况。结果观察组患者手术时间多于对照组(P<0.05),术中积水量、术后引流管保留时间和术后住院时间少于对照组(P<0.05)。随访24个月两组患者腰腹痛、血尿、尿路感染、高血压等临床症状缓解或消失,所有患者术后没有出现梗阻再发,而肾积水均有不同程度改善。B超检查发现,肾盂输尿管连接部位吻合口未见明显狭窄,肾实质厚度有不同程度增加;患者肾功基本恢复正常。观察组患者并发症总率低于对照组(P<0.05)。结论腹腔镜肾积水肾盂输尿管成形术在治疗肾盂输尿管连接部梗阻合并肾积水安全性较佳。Objective To investigate the short-term and long-term effect of laparoscopic dismembered pyeloplasty in the treatment of ureteropelvic junction obstruction with hydronephrosis.Methods A total of 80 cases of ureteropelvic junction obstruction with hydronephrosis in our hospital from December 2016 to December 2019 and divided into two groups by random number table methods,each with 40 cases.Control group received open surgery,while observation group received laparoscopic dismembered pyeloplasty.The general indicators,complication rate,short-term effect,long-term curative effect were compared between groups.Results The operation time of observation group was longer than that of control group(P<0.05),and intraoperative hydronephrosis volume,postoperative drainage tube retention time and postoperative hospital stay time were shorter than those of control group(P<0.05).During the follow-up of 24 months,clinical symptoms such as lumbago and abdominal pain,hematuria,urinary tract infection and hypertension were relieved or disappeared in both groups.No recurrence of obstruction occurred in all patients,and the hydronephrosis was also improved in varying degrees.B-ultrasound examination revealed that there was no obvious stenosis in anastomosis at the junction of the renal pelvis and ureter,and the thickness of the renal parenchyma increased to varying degrees;The renal function of the patients returned to normal.The complication rate of observation group was lower than that of control group(P<0.05).Conclusion Application of laparoscopic dismembered pyeloplasty for ureteropelvic junction obstruction with hydronephrosis has good safety.

关 键 词：肾孟 输尿管 梗阻 肾积水 腹腔镜 肾积水肾盂输尿管成形术 并发症 

分 类 号：R699[医药卫生—泌尿科学]