摘要
【目的】研究重肾、完全性双输尿管、输尿管囊肿并上位肾积水的临床诊治特点。【方法】回顾性分析本院近 10年来收治并经手术证实的此类患者共 16例 ,以排尿不尽感、尿频为主诉就诊者占 6 2 .5 % (10 /16 ) ,尿末时再排脓尿为主诉者占 2 5 % (4 / 16 ) ,外伤后腰痛就诊者占 12 .5 % (2 / 16 ) ;诊断过程中B超发现输尿管囊肿者占 75 % (12 / 16 ) ;IVP上位肾不显影者 16例 ;下位肾显影且集合系统犹如低垂的百合花者 16例 ;CT或MRI可准确提供病变侧形态者 14例 ;8例试行逆形插管造影均不成功 ;术式均采用上位肾及输尿管全长切除术 ,输尿管囊肿去顶术 ;随诊 2个月至 2 6个月。【结果】术前确诊率 10 0 % ,术后下位肾功能良好 ,膀胱排尿、贮尿功能良好。【结论】B超结合CT或MRI是诊断重肾、完全性双输尿管、输尿管囊肿并上位肾积水的首选方法 ,手术方法宜采用上位肾及输尿管全长切除术 ,同时行输尿管囊肿去顶术。
Objective To study the clinical characteristics in diagnosis and treatment of the duplex kidney, with dual ureters and ureteroceles with upper kidney hydrops.Sixteen cases treated in our hospitals with their diagnosis confirmed by operation during recent 10 years were analyzed retrospectively. Ten out of 16 cases (62.5%) came to OPD mainly complaining of urinary frequency and sense of incomplete urination ; 4 out of them (25%) suffered from pyuria at the end of urination; 2 cases(12.5%) suffered from lumbar pain after trauma. Initial B-ultrasound (BU) examination showed ureteroceles in 12 out of 16 cases (75 %). All 16 cases failed to display the upper kidneys during intravenous pyelography (IVP), while their lower kidneys exhibited the shape of bowed-down lily flowers. The CT or magnetic resonance imaging (MRI) checks accurately provided the shape of disease side in all 14 examined cases ; whereas trials of retrograde pyelography failed in 8 cases. Resection of the upper kidneys and ureters in whole length as well as unroofing of the ureteroceles were performed in all cases and followed up for 2 to 26 months.Accuracy rate of diagnosis prior to surgical operations was 100 % . After operation, the renal function of lower kidneys was good and the urination and urinary storage of bladders were properly maintained.[Conclusion]BU in combination with CT or MRI is the first choice for diagnosis of duplex kidneys, complete dual ureters and ureteroceles with upper kidney hydrops. The recommended surgical approach includes resection of the upper kidney and ureters in whole length, with simultaneous unroofing of ureteroceles.
出处
《医学临床研究》
CAS
2004年第8期853-854,857,共3页
Journal of Clinical Research
