钬激光在儿童重度肾积水治疗中的应用

Application of Holmium laser treatment for children serious hydronephrosis

目的探讨钬激光治疗儿童重度肾积水的方法和疗效,提高儿童重度积水肾的保留率。方法应用超声、IVP、CT或MR、肾图等资料诊断重度肾积水和评价保存积水肾的价值,应用内镜直视下钬激光去除梗阻病灶所致重度肾积水19例。结果19例手术顺利完成,梗阻病灶100%解除;随访12个月以上,18例肾积水明显改善,1例无改善。结论儿童肾脏功能恢复能力较强,对于50%肾实质厚度大于2mm以上的重度肾积水肾脏有保留价值。钬激光治疗儿童尿路梗阻肾积水安全、有效,可以处理多种病因。

[Objective] To study methods and curative effect of Holmium laser treatment for children serious hydrenephresis, in orde to elevate remaining ratio of hydreps kidney. [Methods] Diagnosing serious hydrenephresis and evaluating hydreps kidney by utilizing B-ultrasound, IVP, CT, MRI and nephrogram data. 19 patients with serious hydronephresis accepted operation of Holmium laser removal of obstruct focus of infection by endoscope. [Resuits] All 19 operation were successfully completed, and obstruct focus of infection were removaled. Follow up was over 12 months. 18 patients were obviously improved, and one was not improved. [Conclusion] Children kidneys recovery capability is powerful, hydrops kidneys whose 50 percent renal parenchyma thickness exceed 2 millimeter have reservation value. Holmium laser can treat children obstructive hydrenephresis securely and effectively and handle multitude etiopathogenisis.