Wang Wenjie,Song Hongcheng,Xie Xianghui,et al.Experiences of diagnosing and treating ureteropelvic junction obstruction plus ipsilateral primary ureteral reflux[J].Journal of Clinical Pediatric Surgery,2019,18(10):835-838.[doi:10.3969/j.issn.1671-6353.2019.10.007]
肾盂输尿管连接部梗阻合并同侧原发性膀胱输尿管反流诊治分析
- Title:
- Experiences of diagnosing and treating ureteropelvic junction obstruction plus ipsilateral primary ureteral reflux
- Keywords:
- Vesico-Ureteral Reflux; Ureteral Obstruction; Anastomosis; Surgical; Diagnosis; Therapy
- 分类号:
- R726.9;R692.7;R693
- 摘要:
- 目的 探讨肾盂输尿管连接部梗阻（ureteropelvic junction obstruction，UPJO）合并同侧原发性膀胱输尿管反流（vesicoureteral reflux，VUR）的诊治经验。方法 回顾性分析2012年5月至2017年5月8例9侧（左5、右4）肾盂输尿管连接部梗阻合并同侧原发性膀胱输尿管反流患儿的临床资料，并结合文献复习。结果 本研究共8例9侧肾盂输尿管连接部梗阻合并同侧原发性膀胱输尿管反流患儿，其中男童7例，女童1例；年龄8个月至7岁。3例无临床症状，5例表现为尿路感染。5例行肾盂成形术，2例先行输尿管膀胱再吻合术后行肾盂成形术，1例先行肾盂成形术后行输尿管膀胱再吻合术。目前随访15~75个月，均无尿路感染，肾积水明显缓解，5例膀胱输尿管反流仍在随诊过程中，1例症状消失，1例症状减轻。结论 UPJO合并同侧原发性VUR在临床上少见，治疗需综合考虑患儿年龄、症状、反流级别、肾积水轻重度等多个因素，给予个体化治疗。
- Abstract:
- Objective To explore the diagnosis,treatment and prognosis of ureteropelvic junction obstruction (UPJO) plus ipsilateral vesicoureteral reflux (VUR).Methods From May 2012 to May 2017,clinical data of 8 children were retrospectively analyzed along with a literature review. Results There were 7 boys and 1 girl with an age range of 8-84 months.And the involved side was left (n=5) and right (n=4).Three patients had no clinical symptoms while another 5 presented with urinary tract infection (UTI).The procedures included pyeloplasty (n=5),pyeloplasty after ureterovesicostomy (n=2) and ureterovesicostomy after pyeloplasty (n=1).During a follow-up period of 15 to 75 months,there was no onset of UTI and hydronephrosis became markedly alleviated.The outcomes were persistent cystoureteral reflux (n=5),symptom-free (n=1) and relief (n=1).Conclusion Clinical cases of ureteropelvic junction obstruction plus ipsilateral vesicoureteral reflux are rare.Individualized treatments should be offered on the basis of age,symptoms,grade of reflux,severity of hydronephrosis and other factors.
参考文献/References:
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备注/Memo
收稿日期:2018-08-28。
基金项目:北京市医院管理局"登峰"人才培养计划基金资助项目（编号：DFL20151102）
通讯作者:宋宏程,Email:songhch1975@126.com