小儿先天性重度肾积水的外科治疗分析

Clinical efficacy of surgical treatment of severe congenital hydronephrosis

目的探讨外科治疗小儿先天性重度肾积水的临床疗效。方法回顾性分析36例小儿先天性重度肾积水患者的临床资料,分析手术后患肾形态和功能及临床疗效。结果随访时患儿患侧肾实质平均厚度以及肾实质平均面积较术前显著增加(P<0.01)。随访时患侧肾实质平均厚度低于健侧肾(P<0.01),而患侧和健侧肾实质平均面积比较没有差异(P>0.05)。对12例患儿术前术后肾脏功能进行比较,随访时健侧患侧肾滤过分数均显著增加(P<0.01),但患侧肾仍显著低于健侧肾(P<0.01)。随访时肾实质平均面积无尿路感染组显著高于尿路感染组患儿(P<0.01)。结论外科治疗小儿先天性重度肾积水具有较好的临床疗效。

Objective To discuss the clinical efficacy of surgical treatment of severe congenital hydronephrosis. Methods Clinical data of 36 cases with severe congenital hydronephrosis were retrospectively analyzed. Srgical troubles kidney morphology and function, clinical efficacy were analyzed. Results At follow-up, ipsilateral renal parenchymal average thickness and the average size of the renal parenchyma showed a significant increase compared with before surgery（P〈0.01）. At follow-up,the average ipsilateral renal parenchymal thickness was less than the contralateral （P〈0.01）,while the ipsilateral and contralateral renal parenchyma had no difference in the average size comparison （P〉0.05）. Preoperative and postoperative renal function were compared on 12 patients that the results showed ipsilateral kidney filtration fraction significantly increased during follow-up （P〈0.01）, but still significantly lower than the contralateral kidney（P〈0.01）. During follow-up,the average of renal parenchyma surface without urinary tract infection was signif-icantly higher than that in children with urinary tract infection group（P〈0.01）. Conclusion Surgical treatment of chil-dren with severe congenital hydronephrosis shows better clinical efficacy.