下腔静脉后输尿管的诊断与治疗

Diagnosis and treatment of retrocaval ureter

目的总结下腔静脉后输尿管的诊断与治疗方法。方法对7例下腔静脉后输尿管临床资料进行回顾分析。结果7例患者术前均明确诊断，采用输尿管切断复位矫正术治疗，术中切断下腔静脉后有病变的输尿管2～3cm，无张力吻合输尿管。术后随访6个月至10年，所有患者症状消失，肾积水明显减轻。结论下腔静脉后输尿管诊断主要依据多种影像学的协同检查，静脉肾盂造影（IVU）和逆行输尿管肾盂造影是主要的诊断方法，狭窄段切除，输尿管复位成形术效果良好。

Objective To improve the diagnosis and treatment of retrocaval ureter. Methods The clinical data of 7 cases of retrocaval ureter were studied retrospectively. Results All of the 7cases were correctly diagnosed preoperatively. Surgical operation was used to treat this disease. The compressed retrocaval portion of the ureter was resected and end-to-end anastomosis was performed anterior to the vena cava. They were followed up from 6 months to 10 years and satisfactory recovery with disappearance of symptoms and distinct remission of hydronephrosis were achieved. Conclusion The diagnosis of retrocaval ureter depends on the combination of several image methods. Intravenous pyelography and retrograde pyelography are the chief diagnostic procedures. Resection of stenosed ureteral segment and ureteroplasty after reduction will bring about good therapeutic efficacy.