摘要
目的探讨双肾体积比值:一种新的在小儿先天性肾积水术后评价指标的意义。方法结合超声影像的客观表现,针对小儿肾积水术后,提出双肾体积比值的概念及其判断手术效果、评估预后价值,并结合1例肾盂输尿管连接部梗阻(UPJO)患儿术后病情变化验证双肾体积比值的可行性和可靠性。结果患儿于2020年3月24日行腹腔镜下右侧肾盂成形肾盂输尿管再吻合术+输尿管成形术,1月后行右侧输尿管支架取出术。第二次手术术后超声检查提示肾积水持续增加,术后1周复查积水稳定,出院后密切随访彩超。结果提示,术后双肾体积比值大小与预后及术后病情变化相关,比值越趋近于1,肾积水预后越佳,术后情况改善越佳,比值越远离1;肾积水预后情况越差,术后改善情况越不理想。结论双肾体积比值是一种可靠的用于预后评估指标,可避免患儿接受过多CT及核素检查,避免不必要的造瘘及重复插拔双J管,值得临床推广运用。
Objective To investigate the ratio of bilateral kidney volume:a new postoperative evaluation index in children with congenital hydronephrosis and its significance.Methods Combining with the objective performance of ultrasound images,and aiming at the children with hydronephrosis after surgery,the concept of the ratio of bilateral kidney volumes and its value in judging the surgical effect and evaluating the prognosis were proposed.Combined with the postoperative condition changes in 1 cases of ureteropelvic junction obstruction(UPJO),the feasibility and reliability of double renal volume ratio were verified by postoperative changes.Results On March 24,2020,the child was underwent laparoscopic right pyeloplasty ureteric reanastomosis+ureteroplasty and right ureteral stent after January.The ultrasound examination after the second operation indicated that hydronephrosis was stable 1 week after surgery,and closely follow-up after discharge.The results suggest that the postoperative volume ratio of both kidneys is related to the prognosis and the postoperative changes of 1,the better the prognosis,the better the postoperative improvement;the further away from 1,the worse the prognosis,the less ideal the postoperative improvement.Conclusion Ratio of bilateral kidney volumes is a reliable to evaluate prognostic indicators,can avoid children from receiving excessive CT and nuclide examination,avoid unnecessary nephrostomy and repeat the double J tube insertion/extraction,which is worth to clinical promotion.
作者
曾宸
吴素青
陈艳红
翁育娟
陈薇
谢正悦
朱俊腾
ZENG Chen;WU Suqing;CHEN Yanhong;WENG YuJuan;CHEN wei;XIE Zhengyue;ZHU Junteng(Department of Ultrasonic Medicine,Affiliated Hospital of Putian University,Putian,Fujian,351100,China;Department of Pediatric Surgery,Affiliated Hospital of Putian University,Putian,Fujian,351100,China;Department of Rehabilitation Medicine,Affiliated Hospital of Putian University,Putian,Fujian,351100,China)
出处
《当代医学》
2022年第15期16-21,共6页
Contemporary Medicine
基金
福建省中青年教师教育科研项目(JAT200497)。
关键词
双肾体积比值
小儿肾积水
肾盂输尿管连接部梗阻
肾输尿管移行部狭窄
Ratio of bilateral kidney volumes
Congenital hydronephrosis in children
Ureteropelvic junction obstruction
Renal ureter transition stenosis
