摘要
目的 :探讨肾盂输尿管连接部梗阻的最佳治疗方案及引流方式。方法 :报告 63例 ( 70侧 )肾盂输尿管连接部梗阻病人 ,48侧行 Anderson- Hynes肾盂成形术 ,6侧行肾盂瓣输尿管成形术 ,5例行 Y- V成形术 ,1 1例行肾切除术。 8例巨大及重度肾积水病人在 A- H肾盂成形术基础上加肾内翻折叠及肾固定术 ,所有病人均放置输尿管支架引流。1 1例儿童病人应用改良式双 J管内引流。结果 :48侧 A- H肾盂成形术病人术后复查肾盂明显缩小 ,肾功能改善 ,电视动态观察 UPJ处蠕动良好。6侧肾盂瓣输尿管成形术及 5侧 Y- V成形术术后复查肾积水有改善 ,肾盂缩小不明显 ,UPJ处蠕动幅度、频率改善不明显。结论 :A- H肾盂成形术为最佳术式 :巨大肾积水 A- H肾盂成形术加肾内翻折叠及肾固定术不仅改善外观 ,更利于引流及功能的恢复。改良后的双 J管也可用于儿童患者内引流。
Objective:To probe into the best approach for treating PUJO and the means of drainage.Methods:Among 63 cases(70 renes)of PUJO patients,48 received Anderson Hynes pyeloplasty,6 pelviflapureteroplasty,5 Y V pyeloplasty,and 11 nephrectomy.Eight patients with giant and severe hydronephrosis were treated with A H pyeloplasty and an adjunctive nephroplication and nephropexy was performed at the same time and all patients were planted with ureteric stents for drainage.Eleven children patients used improved double J catheters for inner drainage.Results:On post operative check the renal pelvis obviously lessened in the 48 A H pyeloplasty cases,the renal function improved,and the peristalsis at the UPJ was fine on the screen.The hydronephrosis also bettered in 6 cases of pelviflapureteroplasty and 5 Y V pyeloplasty cases,with no remarkable lessening in the renal pelvis or improvement in the peristaltic scope and frequency of the UPJ.Conclusion:A H pyeloplasty is believed to be the best approach.The application of A H pyeloplasty with the aid of nephroplication and nephropexy in treating giant hydronephrosis not only improves appearance but also helps drainage and promotes recovery of the renal funtion.The improved duble J catheter can also be used for inner drainage in children.
出处
《滨州医学院学报》
2000年第4期327-329,共3页
Journal of Binzhou Medical University
关键词
尿路梗阻
肾盂成形术
肾折叠术
支架引流
治疗
urologic obstruction
pyeloplasty
nephroplication
stent drainage
treatment
