腹腔镜离断式肾盂输尿管成形术治疗小儿肾盂输尿管连接部梗阻肾积水的效果  

Therapeutic effect of laparoscopic dismembered pyeloureteroplasty on ureteropelvic junction obstruction complicated by hydronephrosis in children

作　　者：王付建 李付奎 李升辉 孔文龙 Wang Fujian;Li Fukui;Li Shenghui;Kong Wenlong(Department of Pediatric Surgery,Nanyang First People's Hospital,Nanyang 473000,China)

机构地区：[1]南阳市第一人民医院小儿外科,南阳473000

出　　处：《中国实用医刊》2024年第17期10-13,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析腹腔镜离断式肾盂输尿管成形术(DPU)治疗小儿肾盂输尿管连接部梗阻(UPJO)肾积水的效果。方法队列研究。抽取2020年1月至2022年12月南阳市第一人民医院收治的UPJO肾积水患儿66例,按随机数字表法分为开放组和腹腔镜组,每组33例。开放组行开放DPU,腹腔镜组行腹腔镜DPU。对比两组围术期指标、肾功能[肾小球滤过率(GFR)、血肌酐(SCr)、尿素氮(BUN)]、肾盂分离距离、肾盂前后径及并发症发生率。结果腹腔镜组手术时间长于开放组,术中失血量、下床活动时间和住院时间少于开放组(P<0.05)。术后6个月,腹腔镜组GFR水平高于开放组,SCr、BUN水平低于开放组(P<0.05);术后6个月,腹腔镜组肾盂分离距离和肾盂前后径短于开放组(P<0.05)。腹腔镜组并发症发生率(3.03%,1/33)低于开放组(24.24%,8/33),P<0.05。结论腹腔镜DPU治疗UPJO肾积水效果显著,能减少术中出血量,缩短患儿下床活动和住院时间,改善机体肾功能和肾盂前后径,降低切口感染、尿外渗等并发症发生风险。Objective To analyze the application effect of laparoscopic dismembered pyeloureteroplasty(DPU)in children with ureteropelvic junction obstruction(UPJO)complicated by hydronephrosis.Methods A total of 66 children with UPJO complicated by hydronephrosis admitted to Nanyang First People's Hospital from January 2020 to December 2022 were selected for the cohort study.And they were divided into an open group and a laparoscopic group by random number table method,with 33 cases in each group.The open group underwent open DPU,and the laparoscopic group underwent laparoscopic DPU.The perioperative indicators,renal function assessed by glomerular filtration rate(GFR),serum creatinine(SCr)and blood urea nitrogen(BUN),renal pelvis separation distance,anteroposterior diameter of renal pelvis,and the incidence of complications were compared between the two groups.Results The laparoscopic group had longer operation duration,less intraoperative blood loss,shorter time of out-of-bed activity and shorter hospital stay compared with the open group(P<0.05).The GFR level in the laparoscopic group was higher than that in the open group,while the levels of SCr and BUN were lower than those in the open group 6 months after surgery(P<0.05).The renal pelvis separation distance and anteroposterior diameter of the renal pelvis in the laparoscopic group were shorter than those in the open group(P<0.05).The incidence of complication in the laparoscopic group(3.03%,1/33)was lower than that in the open group(24.24%,8/33),P<0.05.Conclusions s Laparoscopic DPU is an effective treatment method for UPJO complicated by hydronephrosis,which can reduce the intraoperative bleeding volume,shorten the time of out-of-bed activity and hospital stay;moreover,it can improve renal function and anteroposterior diameter of the renal pelvis,and reduce the risk of complications,such as wound infection and urinary extravasation.

关 键 词：肾积水 肾盂输尿管连接部梗阻 离断式肾盂输尿管成形术 腹腔镜 

分 类 号：R726.9[医药卫生—儿科]