小儿肾积水经皮肾造瘘后的形态学恢复

The morphological recovery of the hydronephrotic kidney after percutaneous nephrostomy in children

目的研究小儿肾积水经皮肾造瘘后肾形态学恢复的规律,探讨造瘘后手术时间的选择。方法对14例小儿重度肾积水,共15侧积水的肾脏,采用超声引导下经皮穿刺肾造瘘的方法引流尿液,并使用彩色多普勒超声动态观察解除梗阻后肾形态的恢复过程。结果所有病例的肾积水在经皮肾造瘘后肾形态均有恢复。肾积水解除梗阻后,患肾长径和宽径同步恢复,患肾外形与患肾肾盂的也是同步恢复,患肾皮质厚度增加。这一过程在1周内最显著,4周后趋于稳定。结论小儿肾积水经皮肾造瘘4周后,肾形态恢复趋于稳定,可能是进行下一步手术比较恰当的时机。

Objective To investigate the morphological recovery of the hydronephrotic kidneys after the percutaneous nephrostomy（PN）, and estimate the choice of operative time. Methods Fourteen children （including 15 hydronephrotic kidneys） underwent PN for severe hydronephrosis, the recovery process of renal morphology was examined by using doppler ultrasound dynamically. Results After PN, all the hydronephrotic kidneys recovered morphologically. After the obstruction relieved, the length and the width recovered synchronously, the renal profile and the renal pelvis also recovered synchronously, and the renal cortical thickness increased in all hydronephrotic kidneys. The morphological recovery occured mainly in one week after PN, but stabilized after four weeks. Conclusions The morphological recovery of the hydronephrotic kidneys tended to be stabilized at 4 weeks after PN, and it may be the appropriate time for next surgery.