先天性肾盂输尿管连接部梗阻的治疗

Experience in treatment of congenital obstruction of ureteropelvic junction

目的:探讨先天性肾盂输尿管连接部梗阻的治疗方法。方法:113例先天性肾盂输尿管连接部梗阻的患者 ,84例采用 Anderson- Hynes术式治疗 ;17例肾下极异位血管压迫造成的肾盂输尿管连接部梗阻 ,采用血管束悬吊或肾盂下端切断重吻合治疗 ;12例行肾切除。结果 :113例术后随访 3个月～ 5年。异位血管压迫造成梗阻的17例均经手术治愈 ;Anderson- Hynes术式治疗的 84例中 10例吻合口再狭窄 ,3例手术重吻合治愈 ,4例腔内扩张治愈 ,3例肾功能丧失或继发感染切除病肾 ;其余 12例肾切除后治愈。结论:Anderson- Hynes术式是治疗先天性肾盂输尿管连接部狭窄的首选方法 ;异位血管的悬吊移位或肾盂切断重吻合是治疗异位血管压迫造成肾积水的首选方法。

Objective: To study the surgical management of congenital obstruction of UPJ. Methods: All of 113 cases with congenital obstruction of UPJ,84 cases of UPJ stricture were treated with Anderson-Hynes pyeloplasty procedure,17 cases of UPJ obstruction due to overpass of aberrant vessels were treated by displace of vessels or pyeloplasty. The other 12 cases were operated with nephrectomies. Results: Following-up were done 3~60 months. 17 cases with UPJ obstruction due to pressure of aberrant vessels recovered. In Anderson-Hynes group,10 of 84 cases met post-operative re-stricture,3 had to be re-operated,4 received successfully dilation,and 3 had their dysfunction and severe infected kidneys resected. Others were cured.Conclusion: Anderson-Hynes pyeloplasty is the first choice for congenital striction of UPJ.