小儿输尿管囊肿(附20例报告)

Ureteroceles in children (report of 20 cases)

目的对１９９０～１９９８年间收治的２０例输尿管囊肿患者的诊治资料进行总结。方法２０例均行ＩＶＵ及Ｂ超检查。１８例行上肾段及输尿管切除或囊肿切除加膀胱输尿管再吻合术，行经尿道内窥镜囊肿切开及经膀胱双侧输尿管囊肿去顶术各１例。结果Ｂ超诊断符合率为７５％。Ｂ超结合ＩＶＵ诊断符合率达１００％。１３例行上肾段及输尿管切除术，５例行输尿管囊肿切除、输尿管膀胱再吻合术，１例行经尿道内窥镜囊肿切开术，行经膀胱双侧输尿管囊肿去顶术１例。除１例上肾段及输尿管切除术后仍反复泌尿系感染而再行输尿管残端及囊肿切除外，均一次手术治愈。结论Ｂ超及ＩＶＵ二者结合可明显提高诊断符合率。上肾段及输尿管切除或囊肿切除加输尿管膀胱再吻合术方法简单，效果良好，是基本治疗手段之一。对膀胱内型输尿管囊肿、新生儿输尿管囊肿以及输尿管囊肿合并严重泌尿系感染者，可先行经尿道内窥镜囊肿切开术。

Objective To review and evaluate the diagnosis and treatment of 20 cases of ureterocele in children encountered between 1990 and 1998. Methods All the medical documents were reviewed and analysed. Results The accurate diagnostic rate of ultrasonography has been 75% and became 100% when combinedly used with IVU.Upper pole partial nephroureterectom was undertaken for 13 cases with concomitant duplication of renal pelvis and ureter,excision of the ureterocele with reimplantation of the ureter for 5 cases and surgical unroofing for 1 and endoscopic incision for 1.Surgical intervention has been successful in 19 out of 20,further surgical measures being not needed.In the other case after upper pole nephroureterectomy further excision of the ureter remnant and the ureterocele was undertaken because of repeated attacks of urinary tract infection. Conclusions Ultrasonography combinedly used with IVU is an important measure in the diagnosis of ureterocele.Upper pole partial nephroureterectomy or excision of the ureterocele with reimplantation of the ureter is one of the major methods for treatment.Endoscopic incision of the ureterocele should be the treatment of choice for intravesical ureteroceles.