儿童肾盏憩室的鉴别诊断与疗效分析

Antidiastole and treatment of pediatric calyceal diverticulum

目的探讨儿童肾盏憩室的鉴别诊断与诊疗方法。方法回顾性分析本院泌尿外科2009年1月至2017年2月收治的44例肾囊性占位病变患儿临床资料,其中7例诊断为肾盏憩室,总结分析7例肾盏憩室患儿的影像学检查结果、治疗方法以及转归等情况。结果 7例患儿中,女性3例,男性4例;右侧5例,左侧2例;年龄4个月至10岁,平均年龄6.4岁。7例患儿中,3例因腹痛就诊,4例无临床症状,为体检时彩超发现。憩室直径1.4~6.2 cm,平均直径3.8 cm。4例患儿予随访观察,1例经抗感染治疗后腹痛缓解好转出院,2例予腹腔镜手术治疗。随访时间为3个月至8年。5例保守治疗患儿定期随访憩室大小,未见明显变化;2例腹腔镜手术患儿术后恢复良好,无并发症发生,憩室无复发。结论儿童肾盏憩室易与单纯性肾囊肿相混淆,CT增强后延迟扫描对诊断肾盏憩室有较高的检出率。临床应严格把握手术指证。

Objective To explore the clinical manifestations,diagnosis and treatments of pediatric calyceal diverticulum.Methods From January 2009 to February 2017,44 patients with renal cystic disease were analyzed retrospectively.Seven were diagnosed as renal calyceal diverticulum.We retrospectively reviewed their imaging data,treatments and outcomes.Results There were 4 boys and 3 girls with an average age of 6.4(0.3-10)years.The involved sides were right(n=5)and left(n=2).Three cases presented with abdominal pain while another 4 asymptomatic cases were diagnosed by ultrasound.The average diameter of calyceal diverticulum was 3.8(1.4-6.2)cm.Four cases were followed up without any treatment,one received anti-infective treatment and another 2 cases underwent laparoscopy.The follow-up time ranged from 3 mouths to 8 years.The lesions stabilized in size and remained asymptomatic in 5 conservatively treated cases and 2 cases undergoing laparoscopy had neither complications nor recurrence.Conclusion Pediatric calyceal diverticulum may be easily confused with simple renal cysts.And delayed postcontrast computed tomography is highly sensitive in its diagnosis.