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小儿先天性肾积水诊断及治疗 被引量:1

Diagnosis and Treatment of Congenital Hydronephrosis in Children
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摘要 目的探讨小儿输尿管(UPJO)连接梗阻诊断及治疗经验。方法20例UPJO患儿分别行B超、IVU、CT等检查明确诊断,详细了解积水情况,皮质厚度,判断肾功能。采用Anderson-Hynes成形术,并应用双J管内支架引流连肾、肾盂造瘘治疗小儿UPJO。结果术前诊断符合率90%,14例采用由支架连肾造瘘术后有出血、感染、阻管8例,6例采用双J管连肾盂造瘘管无感染、出血、阻管现象。结论小儿UPJO以B超、IVU及CT相结合既能确诊又能判断肾皮质厚度、肾功能,Anderson-Hynes成形术为首选,术中采用双J管连肾盂造瘘管并发症少,使用安全,疗效可靠。 Objective To summarize the experience of diagnosis and treatment in children with ureteropelvic junction obstruction (UPJO). Methods The diagnosis of 20 cases with UPJO were confirmed by type-B ultrasound, IVU and CT examinatlons,which provided valuable indexes to assess the degree of hydronephrosis, thickness of renal cortex and renal function. All the cases were operated with Anderson-Hynes pyeloplasty, internal stent (in 14 cases) or double-J stent (in 6 cases) and a nephrostomy tube were used to sustain and drainage during the operation. Results The coincidence rate of preoperative diagnosis was 90%. Of 14 cases with internal stent, 8 cases had complications of bleeding, infection and/or tube obstruction; but there were not complications in the 6 cases with double-J stent. Conclusions Children with UPJO can be diagnosed and the thickness of renal cortex and renal function can also be evaluated hy type-B ultrasound, IVU and CT. Anderson-Hynes pyeloplasty should be the first choice for the treatment of UPJO, a double-J stent and a nephrostomy tube should be indwelled in the pelvis and ureter during the operation, which is safe and dependable and will significantly reduce the complications.
作者 徐康 尹云言
出处 《基层医学论坛(B版)》 2007年第1期1-2,共2页 Public Medical Forum Magazine
关键词 UPJO 肾积水 Anderson—Hynes成形术 UPJO Hydronephrosis Anderson-Hynes pyeloplasty
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参考文献1

  • 1Ward AM,,Kay R,Ross JH.Ureteropelvic junction obstruction in children Unique considerationsopen operative intervention[].Clinics in Podiatric Medicine and Surgery of North America.1998

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