先天性输尿管瓣膜症16例诊断与治疗分析

Analysis on diagnosis and treatment for 16 cases of congenital ureteral valves

目的探讨先天性输尿管瓣膜症的诊断及治疗方法。方法回顾性分析16例先天性输尿管瓣膜症患者的临床资料。经静脉肾盂造影(IVP)、逆行肾盂造影(RGP)、核磁共振尿路成像(MRU)检查诊断7例,6例通过输尿管镜检查发现并诊断,3例手术探查发现。结果16例患者中,行输尿管端端吻合术2例;手术行输尿管瓣膜切除4例;输尿管镜下钬激光切除瓣膜10例;手术均1次成功,术后平均随访14个月,普通肾图或利尿性肾图提示输尿管梗阻解除。患侧肾积水好转,肾功能改善。结论尿路造影为诊断本症的主要方法。输尿管镜下钬激光切除输尿管瓣膜是一种安全、有效的腔内泌尿外科治疗方法。

Objective To investigate the diagnosis and therapy of ureteral valves.Methods A retrospective analysis was conducted on clinical features about 16 cases of ureteral valves.7 cases were diagnosed by intravenous phelography（IVP）,retrograde pyelogram（GRP） and magnetic resonance urography（MRU）;6 cases by ureteroscopy and 3 cases during operation.Results Among the 16 cases,ureteroureterostomy was performed in 2 cases,ureteral valvulotomy in 4 cases and ureteroscopic holmium laser resection in 10 cases,the successful results were obtained in all of these cases.Patients were followed up for average 14 months.Normal renogram and diuretic renography results showed all those cases were free from problems.Hydronephrosis condition and renal function were improved.Conclusion Urography is the major method to diagnose the illness.ureteroscopic holmium laser resection is an excellent option which can be easily and effectively used for endourology treatment of ureteral valves.