内置双“J”管在小儿肾盂输尿管连接部梗阻中的应用

Application of Built-in Double-J Catheters in Children with Ureteropelvic Junction Obstruction

【目的】探讨双J管内引流术治疗肾盂输尿管连接部梗阻（UPJO）的临床效果。【方法】对156例UPJO所致的肾积水患儿采用双J管内引流术治疗，并与未作任何处理以及手术治疗的患儿作比较。【结果】置管后每月复查B超观察管道位置及肾积水改变情况，3个月后拔管，再次每月复查B超观察肾积水改变情况至半年，积水无减轻甚至加重的病例经第二次置管后同法随诊观察半年后复诊。轻、中度积水病例经置管处理后积水明显减轻，分别占94．7％（54／57）、83．8％（57／68）。重度积水患儿经上述处理积水无改善甚至加重而改行手术治疗的占83．9％（26／31），轻中度肾积水双J管内引流术组与对照组组间比较差异有统计学意义（P〈0．01）。【结论】双J管内引流术治疗UPJO所致肾积水方法简单，住院时间短，可作为轻中度肾积水患儿治疗方法。

[Objective]To explore the clinical effect of double-J catheter drainage in the treatment of ureteropelvic junction obstruction（UPJO）. [Methods] A total of 156 cases of UPJO who had placed double-J catheters were compared with patients without any treatment or only With operation. [Results] B-ultrasound for every month was used to check the position of the catheter and the variation of hydronephrosis after operation. Every double-J catheter was removed in 3 months. B-ultrasound reexamination for every month in a half year after removal was done. Patients with no remission or even more serious were placed double-J catheter for the second time and returned the visit for 6 months. Mild and moderate hydronephrosis was relieved obviously, and the response rate was 94.7% （54/57） in mild group and 83.8% （57/68） in moderate group. Twenty six patients in severe group altered to operation because they had no improvement after conservative treatment （83.9%, 26/31）. Compared with control group, mild and moderate hydronephrosis patients who were placed double-J catheters got a higher remission rate （ P〈0.01）. [Conclusion]The placement of double-J tubes is an effective and simple treatment for patients with UPJO complicated with mild and moderate hydronephrosis. It can also shorten the length of stay.