新生儿先天性重度肾积水诊疗分析
- 摘要:
- 目的探讨产前超声诊断的重度肾积水胎儿出生后围新生儿期的诊断、手术治疗及疗效问题。方法对新生儿期入院的肾积水患儿病例7例进行分析，超声提示4级肾积水，行IVP或 ECT及MRU检查后提示重度UPJO肾积水。6例直接行离断式肾盂成型术（Anderson-Hynes术）。另一例行肾穿刺造瘘术，引流38天后再行肾盂成形术。结果7例患儿均无近期手术并发症。术后随访6月~2年。尿常规未见明显泌尿系统感染。超声提示肾盂分离数值较术前明显改善，肾脏皮质厚度较术前增厚。结论肾积水围新生儿期手术治疗是安全而有效的，因此重度肾积水的新生儿，明确诊断则可积极手术治疗以保存患肾功能。超声检查对于肾积水患儿术前诊断及术后随访有重要意义。
- Abstract:
- Objectives The purpose of the study was to evaluate the diagnosis, operative treatment and outcome of the neonates prenatally detected severe hydronephrosis due to ureteropelvic junction obstruction (UPJO). Methods The records of seven neonatal patients with 4th grade hydronephrosis were reviewed. The patients were performed IVP or ECT scan, and MRU. All cases were found severe hydronephrosis due to UPJO. 6 cases were performed Anderson-Hynes pyeloplasty. One case was performed puncture nephrostomy. After 38 days , Anderson-Hynes pyeloplasty was performed. Results All cases were follow-up from 6 months to 2 years. All of seven cases were without complications of surgery in the recent period. Routine urine tests were normal, all cases didn’t have urinary tract infections. The size of the renal pelvis detected by ultrasound improved compared with before operation. Renal cortex was thicken post-operation. Conclusions Anderson-Hynes pyeloplasty was safe and effective to neonatal patients. The surgery may be performed early in the neonatal patients with severe hydronephrosis due to UPJO. Ultrasonography was useful for preoperative diagnosis of hydronephrosis and post-operative follow-up.
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备注/Memo
广东深圳儿童医院（518026），E-mail：jcyin158@yahoo.com.cn