小儿肾盂输尿管连接部梗阻45例回顾性分析

Ureteropelvic Junction Obstruction: A Retrospective Analysis of 45 Pediatric Patients

目的总结小儿肾盂输尿管连接部梗阻的诊断和治疗经验。方法对45例经手术证实为肾盂输尿管连接部梗阻患儿的临床资料进行回顾性分析,随访术后肾积水的改善情况,并对手术的疗效进行评估。结果本组行核磁共振泌尿系统水成像(MRU)检查18例,诊断与手术探查符合率为100%。本组术后随访25例,时间6个月至3年,复查B超、静脉肾盂造影(IVP),24例术后临床症状消失,肾积水不同程度改善,无再梗阻,手术成功率96%(24/25)。结论 MRU是肾盂输尿管连接部梗阻理想的影像学检查方法;离断性肾盂成形术(Anderson-Hynes术)是肾盂输尿管连接部梗阻首选的手术方法。

Objective To summarize the experience in the diagnosis and treatment of pediatric ureteropelvic junction obstruction.Methods Clinical data from 45 pediatric patients with surgery-confirmed ureteropelvic junction obstruction were retrospectively analyzed.The improvement in postoperative hydronephrosis was followed-up and surgical efficacy was assessed.Results Among the 45 patients who underwent surgical exploration,magnetic resonance urography（MRU） was performed in 18 patients,with a diagnosis rate of 100%.Among the 25 patients who underwent 6 months to 3 years of follow-up examinations with B-mode ultrasound and intravenous pyelography,clinical symptoms disappeared in 24 patients who showed varying degrees of improvement in hydronephrosis and had no re-obstruction,with a surgery success rate of 96%.Conclusion MRU is an ideal imaging examination method and Anderson-Hynes pyeloplasty is the preferred surgical method for pediatric ureteropelvic junction obstruction.