输尿管异位开口诊治体会(附26例报告)

Experience of the diagnosis and treatment for ectopic ureteral orifice (A report of 26 cases)

目的总结输尿管异位开口的诊治经验。方法对26例输尿管异位开口患者临床表现、诊治方法进行回顾性分析。结果26例患者均行B超、IVU检查,CT检查6例,4例行MR检查,膀胱镜检逆行插管造影检查2例,4例从前庭瘘口逆行插入4F输尿管导管造影。联合以上方法于术前确诊24例(92.3%)。8例(30.7%)患者行输尿管膀胱再植术,6例(23.0%)行单侧肾脏切除术,12例(46.1%)行上半肾及输尿管切除术。24例随访3个月～8年(平均2年),疗效满意。结论结合病史、体格检查和联合影像学检查,大多数输尿管异位开口可于术前确诊。输尿管膀胱再植术,上半肾和输尿管切除术及单侧肾脏切除术为有效的治疗方法。

Objective To summarize the experience on the diagnosis and treatment of ectopic ureteral orifice. Methods From 1993 to 2004,26 patients with eetopie ureteral orifice were analyzed retrospectively. Results 26 patients ultrasonography, IVU, CT, MR and retrograde ureterography were used in 26,26,6,4 and 9 patients respectively. The diagnoses were gotten by mention above methods preoperatively in 24 cases （92.4%）. 8 （30.7%）patient underwent ureteral-bladder reimplantation, 6 （23.0%） underwent upper unilateral nephreetomy and 12 （46.1% ） underwent upper heminephrouretereetomy. The 24 patients had been followed up for 6 months to 8 years with an average of 2 years. The curative effect was satisfeetory. Conclusion Most of the eases can be diagnosed preoperatively by utilizing the appropriate methods. Ureterovesiele reimplantation, upper heminephrouretereetomy and unilateral nephreetomy are the effective therapeutic method in the treatment of eetopie ureteral orifice.