巨输尿管症的临床特征(附21例报告)

Clinical feature of megaureter (Report of 21 cases)

目的 :探讨巨输尿管症的临床特征。方法 :对 2 1例巨输尿管症患者均行B超和放射学检查 ;确诊后均行开放手术治疗 ,其中 2例行患肾输尿管切除术 ,余 19例行输尿管下段裁剪整形或折叠后行输尿管膀胱再吻合术。保肾手术者如有输尿管末段 (或 )端狭窄均于术中先行切除。结果 :16例患者获 1～ 3年随访 ,均行IVU复查 ,14例肾积水减轻 ,肾功能较术前有所改善 ,2例无明显变化。结论 :B超、静脉尿路造影 (IVU)、逆行尿路造影(RPG)及膀胱尿道造影是诊断巨输尿管症的主要检查手段 ;输尿管裁剪或折叠加输尿管膀胱吻合术是治疗巨输尿管症的理想手术方式。

Objective:To discuss the clinical feature of megaureter.Methods:21 cases in our hospital were reported. Their clinical symptoms and signs, B-ultrasonic scan(B-US), radiologic data, treatment as well as the results and follow-up were studied.All the 21 cases were administered by surgical intervention, in which 2 cases underwent nephroureterectomy,19 cases were treated by ureteroneocystostomy(UNC) following ureter tailoring or folding.All the patients without nephrectomy were executed to remove the stricture of the ureter if existed.Results:16 of 21 cases were followed-up from 1 year to 3 years.They were checked by intravenous urography(IVU).The result indicated that hydronephrosis and hydroureter reduced in 14 cases, no improvement in 2 cases.Conclusions:B-US,IVP,retrograde urography and cystourethrography are the major examination methods for the megaureter. Ureteroneocystostomy with ureter tailoring or folding is an ideal surgical method for treatment of megaureter.