单中心70例儿童输尿管末端囊肿的钬激光开窗治疗分析  

Analysis of holmium laser fenestration for 70 children with terminal ureteral cysts at a single institution

作　　者：童方运 赵夭望 刘李 何天衢 王智[1] Tong Fangyun;Zhao Yaowang;Liu Li;He Tianqu;Wang Zhi(Department of Urology,the Affiliated Children's Hospital of Xiangya School of Medicine,Central South University(Hunan Children's Hospital),Changsha 410007,China)

机构地区：[1]中南大学湘雅医学院附属儿童医院(湖南省儿童医院)泌尿外科,长沙410007

出　　处：《国际泌尿系统杂志》2025年第1期74-77,共4页International Journal of Urology and Nephrology

基　　金：湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)。

摘　　要：目的探讨经尿道输尿管镜下钬激光开窗引流术治疗儿童输尿管末端囊肿的临床疗效。方法回顾性分析2017年1月至2021年12月本院收治的70例输尿管末端囊肿患儿的临床资料,所有患儿均行经尿道输尿管镜下钬激光囊肿开窗引流术。对比患儿术前、术后的肾盂分离程度、输尿管扩张程度及术前术后的输尿管囊肿大小、膀胱输尿管反流、泌尿系感染情况。结果术后3个月左右复查尿常规及尿培养提示有16例患儿存在泌尿系感染,术后6个月左右复查尿培养及膀胱尿道造影,提示尿培养阳性患儿有4例;2例患儿术后随访6个月,肾积水较前稍减轻,无明显泌尿系感染症状;1例左侧输尿管末端囊肿合并重度肾积水患儿术后反复泌尿系感染;其余63例患儿肾积水明显缓解。术后肾盂分离直径、输尿管扩张直径和输尿管囊肿长径小于术前,差异均有统计学意义(均P<0.05)。术前、术后泌尿系感染患者分别为35例(50.0%)和4例(5.7%),差异有统计学意义(P<0.05)。结论采用经尿道输尿管镜下钬激光囊肿开窗引流术治疗输尿管囊肿合并肾盂积水、输尿管扩张加重、反复泌尿系感染的患儿,手术创伤小,解除梗阻后肾积水改善明显,效果显著。Objective To explore the clinical effect of transurethral ureteroscopy holmium laser fenestration and drainage in the treatment of terminal ureteral cysts in children.Methods The clinical data of 70 children with terminal ureteral cysts admitted to our hospital from January 2017 to December 2021 were retrospectively analyzed.All children underwent transurethral ureteroscopy holmium laser fenestration and drainage.The degree of renal pelvis separation before and after operation,the degree of ureteral dilation,the size of ureteral cyst before and after operation,vesicoureteral reflux and urinary system infection were compared.Results The reexamination of urine routine and urine culture about 3 months after surgery indicated that there were 16 cases of urinary system infection,and the reexamination of urine culture and cystourethra about 6 months after surgery indicated that there were 4 cases of positive urine culture.Two cases were followed up for 6 months after operation,hydronephrosis was slightly less than before,and there were no obvious symptoms of urinary system infection.One case of left ureteral terminal cyst complicated with severe hydronephrosis had recurrent urinary system infection after operation,and the other 63 cases of hydronephrosis had obvious remission.The diameter of renal pelvis separation,ureteral dilation and ureteral cyst after operation were smaller than those before operation,and the differences were statistically significant(all P<0.05).There were 35 cases(50.0%)and 4 cases(5.7%)of patients with urinary tract infection before and after surgery,respectively,and the difference was statistically significant(P<0.05).Conclusions Ureteroscopic holmium laser fenestration for ureteral cyst is used to treat children with ureteral cyst complicated with hydronephrosis,aggravated ureteral dilation,and repeated urinary system infection.The surgical trauma is small,and the hydronephrosis is significantly improved after the removal of obstruction,and the effect is remarkable.

关 键 词：儿童 输尿管囊肿 开窗术 钬激光 

分 类 号：R726.9[医药卫生—儿科]