重复肾并发肾积水的诊治分析

Analysis of Diagnosis and Treatment of Duplicated Kidney Complicated with Hydronephrosis

目的:探讨重复肾并发肾积水的诊治经验。方法:回顾分析7例重复肾并发肾积水患者的临床资料,其中男性2例,女性5例,年龄35~71岁。并发重度肾积水3例,轻度肾积水4例。结果:3例重度肾积水均行肾部分切除术,随访1~3年未见肾积水复发;4例轻度肾积水随访3个月~1年,积水未见明显加重。结论:重复肾并发肾积水患者行静脉尿路造影多能明确诊断,但重度肾积水患者,由于重复肾部分不显影或显影不良,静脉尿路造影难以与巨大肾囊肿鉴别,行CT或CT尿路成像检查对诊断有较大帮助。重复肾并发轻度肾积水可观察随访,并发重度肾积水者应行肾部分切除术。对不典型肾囊肿患者,术中仔细探查囊腔底部可以防止将重复肾并发重度肾积水误诊为巨大肾囊肿。

Objective：To discuss diagnosis and treatment of duplicated kidney complicated with hydronephrosis.Methods： Clinical data of 7 cases of duplicated kidney complicated with hydronephrosis were analysed retrospectively.The group has 2 male and 5 female cases,who are 35~71 years old.Results： 3 cases complicated with serious hydronephrosis underwent partial nephrectomy and relieved after 1~3 years follow-up;4 cases complicated with mild hydronephrosis received no additional treatments and their hydrops were not obvious increased after 3 months^1 year follow-up.Conclusions： For diagnosis of duplicated kidney complicated with hydronephrosis,intravenous urography usually is sufficient,but it is difficult to identify duplicated kidney complicated with serious hydronephrosis and large renal cyst by intravenous urography,since the duplicated renal pelvis and calyces are not develop or underdeveloped.For these cases,CT（CTU） examination was helpful for diagnosis.The duplicated kidney complicated with mild hydronephrosis patients can receive no additional treatments with observation and follow-up,but the patients with serious hydronephrosis should undergo partial nephrectomy.For atypical renal cyst,a careful exploration for bottom of cyst cavity in operation is helpful to prevent misdiagnosing duplicated kidney complicated with hydronephrosis as large renal cyst.