输尿管膀胱连接部狭窄诊治体会  

Diagnosis and treatment of ureterovesical junction stricture (report of 18 cases )

作　　者：姜佑三[1] 董秀哲[1] 金泰乙[1] 范志强[1] 朴元子[1] 

机构地区：[1]延边大学医学院附属医院泌尿外科,吉林延吉133000

出　　处：《中华泌尿外科杂志》2004年第4期246-248,共3页Chinese Journal of Urology

摘　　要：目的　探讨输尿管膀胱连接部狭窄的诊治方法。　方法　回顾性分析 18例输尿管膀胱连接部狭窄的临床资料。男 6例 ,女 12例。平均年龄 4 3岁。左侧 5例 ,右侧 6例 ,双侧 7例。膀胱壁内段狭窄 12例 18侧 ,膀胱前 7例 7侧 (含 1例双侧者 1侧 )。输尿管膀胱再植 7例 7侧 ;经膀胱镜或术中输尿管扩张后 ,留置双J管或细硅胶导尿管 6例 6侧 ;狭窄段纵行切开带蒂膀胱黏膜条翻转输尿管末段成形术 7例 12侧。　结果　 18例术后随访 2个月～ 2 3年 ,全组无输尿管狭窄 ,治愈率78% ,好转率 2 2 %。其中输尿管扩张后 ,留置双J管或细硅胶导尿管治愈率 6 7% (4/ 6 ) ;狭窄段纵行切开带蒂膀胱黏膜条翻转输尿管末段成形术 7例均治愈。输尿管再植术 3例和输尿管末段成形术 5例 ,膀胱造影无膀胱输尿管返流。　结论　经膀胱镜或术中输尿管扩张后留置双J管和狭窄段纵行切开带蒂膀胱黏膜条翻转输尿管末段成形术治疗输尿管膀胱连接部狭窄创伤小 ,疗效满意。Objective To explore the diagnosis and treatment for ureterovesical junction (UVJ) stricture. Methods 18 cases of UVJ stricture were analysed retrospectively,of them unilateral stricture of UVJ in 11(left 5,right 6),bilateral stricture of UVJ in 7.The ureterovesicoplasty was performed in 7 cases.The procedure of passive dilation of the UVJ and placing a double-J stent under endoscopy were performed in 6 cases.The plasticity of UVJ with the mucosa of bladder were performed in 7 cases. Results All cases were followed up 2 months to 23 years and cure rate was 78%,the rate of improvement was 22%.67% of cure rate was achieved by stent placing.The renal function, hydronephrosis were obviously improved after operation and there were no vesicoureteral reflux. Conclusions The passive dilation of the ureter and then placing a double-J stent under endoscopy is a safe and effective measure.The ureterovesicoplasty and the procedure which plasticity of UVJ with the mucosa of bladder are the safe and effective methods.

关 键 词：输尿管膀胱连接部狭窄 临床特点 影像学检查 双J管 手术治疗 肾积水 输尿管膀胱再植术 输尿管扩张术 输尿管末段成形术 

分 类 号：R691.1[医药卫生—泌尿科学]