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先天性输尿管膀胱连接部梗阻的诊断与治疗 被引量:1

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摘要 目的探讨先天性输尿管膀胱连接部梗阻(UVJO)的诊断与治疗。方法2000年3月至2009年6月观察、治疗先天性UVJO患者21例26侧。保守治疗、密切观察5例6侧;手术治疗16例20侧,其中肾重度积水无功能切除肾脏1例1侧,其余手术方式均采用切除狭窄段及抗反流输尿管膀胱再植入手术。11例13侧输尿管膀胱再植入手术前先行扩张输尿管剪裁手术。结果孕期B超发现的3例4侧患儿,观察3年,其中1例2侧输尿管积水消失,1例1侧输尿管积水无进展,1例1侧输尿管积水改善。2例2侧B超发现积水不严重的无症状患者,观察3年。肾积水无进展。16例手术治疗患者术后恢复顺利,住院时间9~14d。10例12侧患者获随访0.5—3.0(2.0±0.8)年。排泄性膀胱尿道造影(VCU)复查示并发膀胱输尿管反流1例1侧,继续观察。B超、静脉尿路造影(IVU)复查示肾脏输尿管积水明显好转9例,无明显变化1例。结论对产前或出生后发现的无临床症状UVJO患儿可动态观察,对积水较轻、无症状的成年患者也可保守治疗、密切观察。抗反流输尿管膀胱再植入术是治疗先天性UVJO的主要手术方式。
作者 高中伟
出处 《中国医师进修杂志》 2011年第32期40-42,共3页 Chinese Journal of Postgraduates of Medicine
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