小儿重肾31例分析

Analysis of duplex kidney in 31 children

目的 探讨小儿重肾的诊断及治疗。方法 对我院 1989～ 2 0 0 1年收治的 3 1例小儿重肾进行回顾性分析。结果 3 1例中有 2 3例患儿接受 2 6次手术 ,有 16例行上半重肾及输尿管切除 ,其中有 2例须处理输尿管残端及盲袋所致的梗阻。 2 2例手术后恢复较好 ,仅 1例伴有轻度的尿失禁。结论 对于重肾伴肾积水或发育不良所致的各种临床表现应首先考虑做上半肾及输尿管大部切除术。B超、CT及静脉肾盂造影术 (IVP)对诊断分型有意义。

Objective To explore the diagnosis and treatment of duplex kidney in children by analyzing 31 cases.Methods There were 31 children with duplex kidney within 12 years,of them 26 cases were females,5 cases were males.Clinical manifestation included urological tract infection with 11 cases (35.48%), obstruction and prolapse of ureterocele with 8 cases (25.81%),urinary incontinence with 6 cases (19.35%),hematureria with 3 cases(9.68%),abdominal mass with 2 cases(6.45%)and urinary frequency with 1 cases(3.23%)respectively. There were 23 cases receiving 26 operations, of which, 16 cases receiving upper pole moiety and partial urinary tract excision. After operation there were two cases requiring further operation to relieve obstruction caused by stump.Results 22 cases recovered uneventfully after operation except one case with slight incontinence.Conclusions Upper pole heminephrectomy should be considered first in dealing with duplex kidney,combining with poor or nonfunctioning upper moieties.B ultrosound, IVP and contrast enhanced delayed computerized tomography are helpful to diagnosis.