输尿管支架管和肾盂造瘘管在小儿Anderson-Hynes术中的应用
- 摘要:
- 目的 评估小儿肾盂输尿管连接处狭窄（UPJO）采用离断式肾盂成形术（Anderson-Hynes）后，放置输尿管支架管和肾盂造瘘管对术后结果的影响。方法 回顾139例因肾盂输尿管连接处狭窄（UPJO）在本院行Anderson-Hynes术，术后放置输尿管支架管和肾盂造瘘管的患儿，对住院时间、术后并发症及拔管时间等问题进行分析。 结果 139例患儿行144侧Anderson-Hynes术，其中5例为双侧。术后23例出现并发症：12例（8.3%）血尿、2例尿路感染（1.4%）、1例尿性囊肿（0.7%）、2例（1.4%）暂时性吻合口梗阻、2例（1.4%）尿漏。肾周引流管去除平均时间4.2 d。输尿管支架管平均去除时间为9.6 d。肾盂造瘘管平均去除时间为13.3 d。平均住院天数14.8 d。术后随访0.5 ～24个月，没有发现因吻合口再次梗阻等原因需再次手术治疗的病例。 结论 小儿肾盂成形术后使用输尿管支架管和肾盂造瘘管引流，减少了尿漏和吻合口狭窄发生的可能，同时也未增加术后尿路及切口感染机会。此外，最重要的是不需要再次麻醉下拔管。
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备注/Memo
温州医学院育英儿童医院小儿外科(浙江省，325000)，通讯作者：陈肖鸣， E-mail:cxm@wzmc.net