先天性肾盂输尿管连接部梗阻的临床病理分析

Clinicopathological analysis of congenital ureteropelvic junction obstruction

目的研究先天性肾盂输尿管连接部梗阻(UPJO)的发病因素。方法采用常规病理、特殊染色、免疫组化染色和电镜检查,观察95例UPJO的病理改变。结果60例(63.2%)UPJO病例平滑肌纤维中见较多纤维组织无序增生,使平滑肌纤维排列紊乱,肌层厚度明显增加,电镜示平滑肌细胞内线粒体肿胀,细胞间隙内充满了胶原纤维;23例(24.2%)UPJO病例黏膜息肉形成或息肉样增生,12例(12.6%)UPJO病例为机械性梗阻。结论UPJO的形成有多方面的原因,局部的纤维组织的增生及平滑肌细胞的发育异常是UPJO的主要原因。

To investigate the causes of congenital ureteropelvic junction obstructionc（UPJO）. Methods Ninety-five cases of UPJO were observed with pathological examination, special stains, immunohistochemical stains and electron microscope. Results Sixty （63.2%） cases of UPJO revealed the fibrous tissues hyperplasia and derangement. The smooth muscular fibers could be found disorder for arrangement. Under electron microscope, the mitochondria in smooth muscular ceils were swelling, and the space among the ceils were filled with collagen fibers. Twenty-three （24.2%） appeared polyp or polypoid growth, and 12 （12.6%） were mechanical obstruction. Conclusion The causes of UPJO are diverse, with the main causes of proliferation of fibrous tissues and abnormal development of smooth muscular ceils.