不同输尿管成形术治疗复发性肾盂输尿管连接部梗阻的效果及安全性比较  

Comparison of the Efficacy and Safety of Different Ureteroplasty in the Treatment of Recurrent Ureteropelvic Junction Obstruction

作　　者：张殿锋 陈龙龙 杨银涛 ZHANG Dianfeng;CHEN Longlong;YANG Yintao(Department of Urology,Xuchang Central Hospital,Xuchang 461000,China)

机构地区：[1]许昌市中心医院泌尿外科,河南许昌461000

出　　处：《河南医学研究》2025年第1期108-111,共4页Henan Medical Research

摘　　要：目的探讨两种腹腔镜下输尿管成形术在复发性肾盂输尿管连接部梗阻(UPJO)中的疗效及安全性。方法选取许昌市中心医院2020年1月至2022年1月收治80例复发性UPJO患者作为研究对象,按照随机分组法分为对照组(接受腹腔镜下肾盂瓣成形术治疗,40例)与观察组(接受腹腔镜下狭窄段切除+肾盂离断成形术治疗,40例),随访时间6个月。观察两组围手术期指标、肾动脉血流动力学、肾功能、临床疗效、并发症。结果观察组除出血量外各项围手术期指标参数均低于对照组(P<0.05)。术后6个月,观察组肾动脉阻力指数(RI),舒张期峰值速度(PD)高于对照组(P<0.05),血流收缩期峰值流速(PS)低于对照组(P<0.05)。观察组双侧肾小球滤过率(GFR)高于对照组(P<0.05),血肌酐(SCr)、尿素(BUN)低于对照组(P<0.05)。观察组总有效率与对照组患者比较,差异无统计学意义(P>0.05)。观察组疼痛、切口感染、尿外渗、发热等并发症发生率低于对照组(P<0.05),随访复发率与对照组比较,差异无统计学意义(P>0.05)。结论腹腔镜下狭窄段切除+肾盂离断成形术治疗UPJO能够促进患者恢复,提升肾功能,改善肾动脉血流动力学,提升临床疗效,降低并发症发生风险,值得临床推广。Objective To investigate the efficacy and safety of two kinds of laparoscopic ureteroplasty in the treatment of recurrent ureteropelvic junction obstruction(UPJO).Methods A total of 80 patients with recurrent UPJO admitted to Xuchang Central Hospital from January 2020 to January 2022 were selected as the research objects.According to the random grouping method,they were divided into the control group(treated with laparoscopic pyeloplasty,40 cases)and the observation group(treated with laparoscopic stenoplasty+pyeloplasty,40 cases).The follow-up time was 6 months.The perioperative indexes,renal artery hemodynamics,renal function,clinical efficacy and complications of the two groups were observed.Results All perioperative parameters except the amount of bleeding in the observation group were lower than those in the control group(P<0.05).At 6 months after operation,the renal artery resistance index(RI)and peak diastolic velocity(PD)in the observation group were higher(P<0.05),and the peak systolic velocity(PS)of blood flow was lower(P<0.05).The bilateral glomerular filtration rate(GFR)of the observation group was higher(P<0.05),and the serum creatinine(SCr)and blood urea nitrogen(BUN)were lower(P<0.05).There was no difference in the total effective rate(P>0.05).The incidence of complications such as pain,incision infection,urine extravasation and fever in the observation group was lower(P<0.05),and there was no difference in the recurrence rate of follow-up(P>0.05).Conclusion Laparoscopic resection of stenosed segment and pyeloplasty for UPJO can promote the recovery of patients,improve renal function,improve renal artery hemodynamics,improve clinical efficacy,and reduce the risk of complications,which is worthy of clinical promotion.

关 键 词：腹腔镜下狭窄段切除 肾盂离断成形术 肾动脉血流动力学 并发症 

分 类 号：R692[医药卫生—泌尿科学]