摘要
目的探讨经尿道输尿管口囊肿电切术对重复肾输尿管畸形合并异位输尿管口囊肿致肾盂、输尿管积水的治疗效果。方法选取2013年1月至2021年6月海军军医大学(第二军医大学)第一附属医院收治的9例重复肾输尿管畸形合并异位输尿管口囊肿患者,其中患侧腰部酸痛3例、排尿困难2例、反复尿路感染2例。9例患者术前均行泌尿系超声、静脉尿路造影、泌尿系增强CT尿路成像和膀胱镜检查确诊,均采用经尿道输尿管口囊肿电切术治疗。结果9例患者手术均一次成功,手术时间20~40 min,平均(28.3±7.5)min,术中出血均少于20 mL,3例患者术中放置双J管,术后膀胱冲洗,引流液颜色清亮,所有患者均于术后24 h内停止膀胱冲洗,术后2~3 d拔除导尿管并出院,术后平均住院天数(2.4±1.6)d。术后6~8周拔除双J管,术后随诊1~24个月复查超声,9例患者肾积水均减轻,仅有3例患者仍有轻度积水,无腰酸、腰痛、排尿困难等症状,尿路感染未见复发。结论经尿道输尿管口囊肿电切术具有创伤小、恢复快、术后并发症少、患者接受度高等优点,可作为有手术指征的伴有输尿管口囊肿的重复肾输尿管畸形患者的首选治疗方式。
Objective To investigate the effectiveness of transurethral resection of ureterocele in the treatment of hydronephrosis or hydroureter caused by duplex kidney and deformity of ureter combined with ectopic ureterocele.Methods Nine patients with duplex kidney and deformity of ureter combined with ectopic ureterocele,who were admitted to The First Affiliated Hospital of the Naval Medical University(Second Military Medical University)from Jan.2013 to Jun.2021,were enrolled,including 3 patients suffered from lumbago,2 patients suffered from dysuria,and 2 patients suffered from recurrent urinary tract infection.All patients were diagnosed by urinary ultrasound,intravenous urography,enhanced computed tomography urography,and cystoscopy before operation.All patients underwent transurethral resection of ureterocele.Results The operation was performed successfully on all patients.The operation time was 20-40 min,with an average of(28.3±7.5)min,and the average intraoperative bleeding was less than 20 mL.Double-J stent insertion was used in 3 patients during the operation.The drainage fluid in bladder irrigation was limpid,and bladder irrigation was stopped within 24 h after surgery.The catheters were removed and patients were discharged 2-3 d after surgery.The average postoperative hospital stay was(2.4±1.6)d.The double-J stent was removed 6-8 weeks after the operation.The patients were followedup after postoperative 1-24 months with ultrasound examination,and all hydronephrosis was relieved,except 3 patients who still had mild hydronephrosis.The symptoms such as soreness of loins,lumbago and dysuria disappeared,and there was no recurrence of urinary tract infection.Conclusion Transurethral resection of ureterocele has advantages of minimal invasion,quick recovery,few complications and high acceptance of patients.It can be the first choice for patients with duplex kidney and deformity of ureter combined with ureterocele with surgical indications.
作者
花梅免
杨庆
张振声
高红亮
杨军
肖城武
叶宸
许传亮
HUA Mei-mian;YANG Qing;ZHANG Zhen-sheng;GAO Hong-liang;YANG Jun;XIAO Cheng-wu;YE Chen;XU Chuan-liang(Department of Urology,The First Affiliated Hospital of Naval Medical University(Second Military Medical University),Shanghai 200433,China)
出处
《海军军医大学学报》
CAS
CSCD
北大核心
2022年第12期1481-1484,共4页
Academic Journal of Naval Medical University
