LDP术治疗UPJO肾积水患儿的疗效及对肾功能的影响

The Effect of LDP on Children with UPJO Hydronephrosis and Its Influence on Renal Function

目的探讨腹腔镜离断式肾盂输尿管成形术(LDP)治疗肾盂输尿管连接部梗阻(UPJO)肾积水患儿的疗效及对肾功能的影响。方法回顾性选取2019年1月~2022年1月就诊于宁夏回族自治区人民医院的85例UPJO肾积水患儿,按照手术方法分为观察组(43例,给予LDP)和对照组(42例,给予开放肾盂成形术)。对比两组手术指标(手术时间、住院费用、术中出血量、肾周引流总量、术后镇痛剂用量、住院时间)、肾功能、肾形态和并发症发生情况。结果观察组术中手术时间和住院费用与对照组比较,显著增多(P<0.05);术中出血量、肾周引流总量、术后镇痛剂用量和住院时间与对照组比较,均显著减少(P<0.05)。术后两组肾小球滤过率(GFR)较术前均显著升高,血肌酐(Scr)水平较术前均显著降低(P<0.05)。但术后两组GFR和Scr水平比较,差异无统计学意义(P>0.05)。观察组术后并发症发生率显著低于对照组(P<0.05)。术后两组肾体积均较术前显著减小(P<0.05),肾实质厚度均较术前显著升高(P<0.05)。但两组肾体积和肾实质厚度比较,差异无统计学意义(P>0.05)。结论LDP术治疗UPJO肾积水患儿的疗效显著,促进肾功能、肾脏形态恢复,减少术后并发症。

Objective To investigate the eff ect of laparoscopic ureteropelvic plasty(LDP)on hydronephrosis in children with ureteropelvic junction obstruction(UPJO)and its infl uence on renal function.Methods A retrospective selection of 85 children with UPJO hydronephrosis who were treated in the People's Hospital of Ningxia Hui Autonomous Region from January 2019 to January 2022 were selected and divided into observation group(n=43,LDP)and control group(n=42,open pyeloplasty)according to the surgical methods.Operation indexes(operation time,hospitalization expenses,intraoperative blood loss,total amount of perirenal drainage,postoperative analgesic dosage and hospitalization time),renal function,renal morphology and complications were compared between the two groups.Results Compared with the control group,the operation time and hospitalization expenses in the observation group increased signifi cantly(P<0.05).Compared with the control group,blood loss during operation,the total amount of perirenal drainage,postoperative analgesic dosage and postoperative hospitalization time were signifi cantly reduced(P<0.05).After operation,the glomerular fi ltration rate(GFR)of both groups was signifi cantly higher than that before operation,and the Serum creatinine(Scr)level was significantly lower than that before operation(P<0.05).However,there was no signifi cant diff erence in GFR and Scr levels between the two groups(P>0.05).The incidence of postoperative complications in the observation group was signifi cantly lower than that in the control group(P<0.05).After operation,the renal volume of both groups decreased signifi cantly(P<0.05)and the renal parenchyma thickness increased signifi cantly(P<0.05).However,there was no signifi cant diff erence in renal volume and renal parenchyma thickness between the two groups(P>0.05).Conclusion LDP is eff ective in the treatment of children with UPJO hydronephrosis,which can promote the recovery of renal function and renal morphology and reduce postoperative complications.