带蒂腰大肌肌瓣治疗肾下垂285例

Psoas muscles vane with pedicle flap in the treatment of nephroptosis of 285 cases

目的总结带蒂腰大肌肌瓣治疗症状性肾下垂的疗效。方法回顾性分析285例症状性肾下垂患者的临床病例资料,术前均行腹部平片和静脉尿路或逆行平卧与站立位的肾盂造影对比证实为肾下垂,均采用带蒂腰大肌肌瓣行肾固定术。结果285例患者中共461个下垂肾脏,其中425个肾脏行手术处理(其余36个肾脏不需手术处理);手术时间为40-85min(平均60.5min),术后卧床时间为6-12d(部分患者同期处理合并症,平均7.22d);共261例患者获IVU、RP或CT随访(91.58%),随访时间1-10年(平均6.2年),未见复发及严重的手术并发症;患者对手术总体满意率为96.14%。结论带蒂腰大肌肌瓣肾固定术是治疗症状性肾下垂的安全、有效、简便的治疗方法。

Objective To study the clinical effects of treatment of nephroptosis with psoas muscles vane with pedicle flap. Methods The clinical data of 285 patients with nephroptosis from 1985 to 2006 were retrospectively analyzed. Nephroptosis were proved by plain abdominal radiograph, intravenous pyelography （IVU） or retrograde pyelography （RP） in all patients preoperative. Nephropexia with psoas muscles vane with pedicle flap were performed in all patients. Results There were 461 kidneys of nephroptosis in 285 patients, and 425 kidneys received nephropexia with psoas muscles vane with pedicle flap （The other 36 kidneys did not need surgical procedures）. The operative time was 40--85 min （mean 60.5 min）, the time of bed rest post-operative was 6--12 d （mean 7.22 d）. IVU, RP or CT results of 261 cases of the 285 patients showed no recurrence or severe operation complications during 12 months--10 years of follow-up （mean 6.2 years）. Oonclusion Psoas muscles vane with pedicle flap is a safe, effective and economical method to treat nephroptosis.