腹腔镜肾盂成形术与传统肾盂成形术治疗小儿肾积水疗效对比研究

Comparative analysis of the effect of laparoscopic pyeloplasty and traditional pyeloplasty in children with hydronephrosis

目的:观察腹腔镜肾盂成形术与传统肾盂成形术在小儿肾积水中的应用效果。方法:60例小儿肾积水患者随机分为对照组、观察组,对照组采用传统肾盂成形术治疗,观察组采用腹腔镜肾盂成形术治疗。比较两组手术指标、术后并发症、治疗前后肾血流动力学指标变化、血β_2-MG、α_1-MG、Scr水平变化。结果:两组手术时间、术中出血量、进食时间、住院时间比较,差异均无统计学意义(P>0.05)。两组术后尿路感染、吻合口尿漏、吻合口梗阻、肠梗阻等并发症发生率差异无统计学意义(P>0.05)。治疗后,两组肾血流动力学指标PS、ED、TAMx、TAMn均显着高于同组治疗前(P<0.05)。治疗后,观察组PS、ED、TAMx、TAMn显着高于对照组(P<0.05)。治疗后,两组血清β_2-MG、α_1-MG水平均显着低于同组治疗前(P<0.05)。治疗后,观察组血清β_2-MG、α_1-MG水平显着低于对照组(P<0.05)。结论:采用腹腔镜式肾盂成形术治疗小儿肾积水,可显著改善患儿血流动力学状态,改善肾功能。

Objective:To observe the application effect of laparoscopic pyeloplasty and traditional pyeloplasty in children with hydronephrosis.Methods:Sixty patients with hydronephrosis were randomly divided into control group and observation group.The control group was treated with traditional pyeloplasty.The observation group was treated with laparoscopic pyeloplasty.Surgical indexes such as operation time,hospitalization time,and intraoperative blood loss were compared between the two groups to compare the occurrence of postoperative fruit complications.The changes of renal hemodynamic parameters and bloodβ2-MG,α1-MG and Scr levels were compared before and after treatment.Results:There were no significant differences in operation time,intraoperative blood loss,eating time,and hospital stay time between the two groups(P>0.05).There was no significant difference in the incidence of postoperative urinary tract infection,anastomotic leakage,anastomotic obstruction,and intestinal obstruction between the two groups(P>0.05).After treatment,PS,ED,TAMx and TAMn were significantly higher in the two groups than before treatment(P<0.05).After treatment,the PS,ED,TAMx and TAMn in the observation group were significantly higher than the control group(P<0.05).After treatment,the serum levels ofβ2-MG andα1-MG in the two groups were significantly lower than those in the same group before treatment(P<0.05).After treatment,the levels of serumβ2-MG andα1-MG in the observation group were significantly lower than the control group(P<0.05).Conclusion:Laparoscopic pyeloplasty for children with hydronephrosis can significantly improve the hemodynamic status of children and improve renal function,which is suitable for clinical application.