Wang Yusi,Ren Zhentao,Zhang Weiping,et al.Clinical diagnosis and treatment of hydronephrosis caused by ureteral fibroepithelial polyp in children[J].Journal of Clinical Pediatric Surgery,2021,20(11):1026-1030.[doi:10.12260/lcxewkzz.2021.11.006]
儿童输尿管纤维上皮性息肉致肾积水的临床特点及诊治与结果分析
- Title:
- Clinical diagnosis and treatment of hydronephrosis caused by ureteral fibroepithelial polyp in children
- 关键词:
- 输尿管纤维上皮性息肉; 肾积水/诊断; 肾积水/治疗; 儿童
- 分类号:
- R726.92;R693
- 摘要:
- 目的 探讨输尿管纤维上皮性息肉（ureteral fibroepithelial polyp，UFP）致肾积水患者的临床特点、诊疗方法与临床疗效。方法 回顾性分析首都医科大学附属北京儿童医院泌尿外科2006年9月至2019年9月期间所有肾积水手术后病理诊断为UFP患者的一般情况、临床表现、影像学检查、手术方式及随访情况。结果 肾积水手术后病理组织学诊断为UFP患者48例，占同期肾积水手术治疗患者总数的1.8%（48/2 653）。患者平均就诊年龄（109.2±34.7）个月，男童为主（95.8%），左侧多见（81.3%），主要临床表现为腹痛（81.3%）及肉眼血尿（18.8%）。术前泌尿系统超声（ultrasonography，US）阳性检出率为60.4%，静脉肾盂造影阳性检出率为34.1%。所有病例的息肉经手术完整切除，术中见70.8%的息肉为单一带蒂型，97.9%的息肉位于输尿管近段，息肉中位长度为1.5 cm（0.3~8.0 cm）。术后均获随访，中位随访时间57个月（3~141个月），无一例息肉复发；3例（6.3%）出现术后并发症，其中2例为青春期同侧输尿管结石。结论 儿童UFP发病率较低，具有典型的临床特征，超声在术前诊断UFP方面具有一定价值，手术治疗效果明确，术后息肉残留少，复发率低，但存在远期并发症的可能。
- Abstract:
- Objective To explore the clinical features of children with ureteral fibroepithelial polyp (UFP) causing hydronephrosis and boost its levels of diagnosis and treatment. Methods From September 2006 to September 2019, general profiles, clinical manifestations, imaging examinations, surgical approaches and follow-ups were retrospectively reviewed for 48 children with a postoperative pathological diagnosis of UFP. Results They accounted for 1.8%(48/2653) of patients with hydronephrosis during the same period. The mean age was (109.2±34.7) months. Boys predominated (95.8%) and occurred unilaterally in left ureter (81.3%). The major symptoms were flank pain (81.3%) and hematuria (18.8%). The positive rate of ultrasonography was 60.4% and intravenous pyelography merely 34.1%. All polyps were completely resected. The lesions were mostly located in proximal ureter (97.9%) with single predominance (70.8%). The median length of polyps were 1.5 (0.3-8.0) cm. The mean follow-up period was 57(3-141) months. Postoperative complications occurred in 3 children (6.3%), including long-term complications (n=2). Conclusion Ureteral fibroepithelial polyps are rare and yet have typical clinical features. Ultrasonography is a noninvasive and effective tool of detecting UFP in children. Resection efficacy is definite with a low recurrence rate. However, clinicians should prolong the postoperative follow-up period to prevent long-term complications.
参考文献/References:
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备注/Memo
收稿日期:2020-12-06。
基金项目:北京市医院管理局儿科协同发展专项子课题（编号：XTZD20180303）
通讯作者:张潍平,Email:zhangwp59616406@126.com