摘要
目的探讨小儿先天性肾盂输尿管连接部梗阻的临床、病理特点和诊治。方法总结1956—2005年北京儿童医院收治的1376例小儿先天性肾盂输尿管连接部梗阻患者的临床和病理资料。患儿年龄3个月-15岁，男1169例，女207例；左侧894例，右侧309例，双侧173例。早期行Y-V成形术97例，1965年以后采用离断性肾盂成形术（Anderson—Hynes术式）1279例。结果术后随访6—36个月，一次手术成功率达98．5％（1355／1376）。手术及术后病理证实，绝大部分小儿肾积水是因先天性肾盂输尿管连接部狭窄所致（占94．3％），其他还有肾盂输尿管连接部瓣膜、息肉、高位输尿管口、迷走血管或副血管压迫肾盂输尿管连接部。结论小儿先天性肾盂输尿管连接部梗阻以男孩多见，部位以左侧多见。先天性肾盂输尿管连接部狭窄是造成小儿肾积水的首要病因。有明显梗阻症状、肾盂进行性扩张或肾功能损害进行性加重者需行离断性肾盂成形术。
Objective To investigate the pathologic characteristics, clinic manifestations, diagnosis and treatment of congenital hydronephrosis caused by ureteropelvic junction obstruction （UPJO） in children. Methods 1 376 children （ male 1 169 and female 207, left side in 894, right side in 309 and bilateral in 173 ） with UPJO were treated in our hospital during the last ：50 years, including 1 279 Anderson-Hynes and 97 Y-V procedures. Results All patients were followed up for at least 6 months. Congenital hydronephrosis are most commonly caused by ureteropelvic junction stenosis （ 94. 3% ）, upper ureteral valve, upper ureteral polyps and an aberrant, accessory or early branching vessel to the lower pole of the kidney as well. Conclusion The most common cause of ureteropelvic junction obstruction is ureteropelvic junction stenosis. Anderson-Hynes procedure should be applied to children with obstructive symptoms and ultimately damaged renal function.
出处
《首都医科大学学报》
CAS
2007年第1期121-123,共3页
Journal of Capital Medical University
关键词
先天性畸形
肾积水
病理
congenital anomalies
hydronephrosis
pathology
