聚丙烯网带经12肋悬吊术治疗肾下垂的远期疗效观察

The Observation of Prostecdtive Efficacy of Nephroptosis Treatment by Polypropylene Reticular Belt Ventrofixation by Twelfth Rib

目的:探讨聚丙烯网带经12肋悬吊术治疗肾下垂的远期疗效。方法:采用聚丙烯网带经1 2肋悬吊术治疗肾下垂患者32例,术后6、12、24、36、48、60个月进行随访。结果:32例患者中,获24个月以上随访者28例,随访24～48月者19例,随访48～60个月者10例。术后经站立位B超、KUB+IVU等复查,1例由术前Ⅳ度恢复至Ⅰ度,余均恢复正常位置。2例因术前重度积水,术后出现肾萎缩、肾性高血压而行肾切除;4例术后复发,给予中药排石和(或)ESWL、输尿管镜下钬激光碎石治疗;2例经确诊合并有腺性膀胱炎,给予TURBT及羟基喜树碱灌注治愈;1例术后确诊为肾盂肿瘤而行肾输尿管全长切除术;术前合并Dietl危象者1例随访无复发。结论:聚丙烯网带经12肋悬吊术治疗肾下垂是一种操作安全、并发症少、治愈率高、远期效果好的方法。

Objective：To investigate the prostecdtive efficacy of nephroptosis treatment by polypropylene reticular belt ventrofixation by twelfth rib. Methods：32 patients of nephroptosis were treated by polypropylene reticular belt ventrofixation by twelfth rib. We analyzed retrospectively the clinic data and the following up results of 6, 12,24,36,48 and 60 months post surgery. Results： In 32 cases, 28 cases had been followed up by above 24 months, 19 cases had been followed up between 24 and 48 months and 10 cases between 48 and 60months. All cases were rechecked by type-B ultrasonic of erect position, KUB and IVU, etc. lcase of preoperative 1V grade recovered to I grade and the other cases recovered to normal position. In 32 cases, 2cases of severe dropsy had been taken kidney excision because of nephrarctia, renal hypertension after operation. 4 cases that recurred stone had been removing urinary calculus by Chinese herbal drugs or EWSL or holmium laser operation. 2 cases had been made a definite diagnosis combined with cystitis glandularis and cured by TURBT and pour hydroxy camptothecin. 1 case had been made a definite diagnosis of tumor of renal pelvis and been taken kidney and ureter ablation, lease combined with Dietl syndrome had no recurrence. Conclusions： The methods of nephroptosis treatment by polypropylene reticular belt ventrofixation by twelfth rib is safely operated and have few complications, high recovery rate and good long term efficacy.