肾盂输尿管连接处梗阻的手术治疗

The operative treatment of ureteropelvic junction obstruction

目的：探讨肾盂输尿管连接处梗阻(PUJO)的手术方法。方法：本组42例中采用非离断性肾盂成形术17例，其中单纯粘连带切断松解术4例，肾盂裁剪加连接处松解术5例，肾盂YV成形术8例；离断性肾盂成形术25例。结果：42例中38例获得随访，其中非离断性肾盂成形术16例，7例肾积水明显减轻（43.8%），６例无变化，3例加重；离断性肾盂成形术22例，20例肾积水明显改善（90.9%），2例肾积水改善不明显但未加重。两种手术方法的疗效比较采用χ2检验，P＜0.05，差异有显著性意义。结论：离断性肾盂成形术是治疗PUJO的理想方法。

Purpose: To evaluate the surgical method of ureteropelvic junction obstruction (UPJO).Method: Dismembered pyeloplasty was performed in 25 cases, continuity pyeloplasty in 17 cases in which the division of aberrant vessels was performed in 4 cases, pyelo clip and pelvioureterolysis in 5 cases, Y V pyeloplasty in 8 cases.Results: Thirty eight of 42 cases (93%) had been followed up in which continuity pyeloplasty group was 16 cases, dismembered pyeloplasty group 22 cases. For continuity pyeloplasty, hydronephrosis was significant improved in 7 (43.8%) cases, failed in 6 cases, worsened in 3 cases. For dismembered pyelopasty, significant improved in 20 (90.9%) cases, failed in 2 cases. The χ2 test shows significant difference (P＜0.05).Conclusion: Dismembered pyeloplasty is a good surgical method for UPJO.