摘要
目的 :探讨先天性血管压迫致输尿管梗阻的诊断与治疗方法。方法 :术前采用 B超、静脉尿路造影(IVU)、逆行尿路造影和磁共振水成像 (MRU)诊断先天性血管压迫致输尿管和肾积水患者 19例 ,均采用手术治疗 ,术中切断腔静脉后输尿管、切除异位血管和切除受压部分输尿管后作输尿管端端吻合或肾盂整形术。结果 :手术证实下腔静脉压迫致输尿管梗阻 8例 ,异位血管压迫致输尿管梗阻 10例 ,左侧髂总动脉压迫致输尿管梗阻 1例。术后 3～ 6个月随访 ,肾脏、输尿管积水减轻 ;术后 1～ 4.5年 (平均 1.4年 )随访 ,18例患者肾脏、输尿管积水明显减轻 ,肾功能良好 ;1例患者肾积水虽减轻 ,但出现肾脏萎缩 ,肾功能不良。结论 :先天性血管压迫是输尿管和肾积水的原因之一 ;B超、IVU和 MRU结合 MRI、腔静脉造影和彩色多普勒超声检查对先天性血管压迫致输尿管梗阻的诊断有较大价值 ;手术仍是治疗先天性血管压迫致输尿管梗阻的首选方法。
Purpose:To clarify the diagnosis and management of ureteral obstruction owing to vena cava or congenital crossing vessels.Methods:Preoperative sonography, intavenous urography(IVU),retrograde urography or magnetic resonance urography(MRU) were performed in 19 cases of patients for evaluation of hydroureteronepherosis.Combined with magnetic resonance imaging(MRI) or cavography, retrocaval ureter could be detected. Colour Doppler imaging was used to detect crossing vessels. During operations, retrocaval (8 cases) or retroiliac (1 cases) ureters were excised, crossing vessels (10 cases) were divided then ureteroureteral anastomosis or dismembered pyeloplasty (Anderson-Hynes) were completed. Results:3 to 6 months after operations, hydroureteronepherosis was lightened to different extends in all patients.After median follow-up of 15.7 months(range 1 to 4.5 years), hydroureteronepherosis was found in one patient.Conclusions:Disorder of blood vessels should be considered in the differential diagnosis of extrinsic ureteral obstruction. Sonography, IVU, MRI combined with cavography, color Doppler imaging are of great value in the diagnosis of those conditions. Early diagnosis and treatment are very important.
出处
《临床泌尿外科杂志》
2000年第10期457-459,共3页
Journal of Clinical Urology
关键词
输尿管梗阻
血管压迫
诊断
治疗
Ureteral obstruction Vessels crossing Diagnosis Treatment
