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先天性巨输尿管症 附10例报告 |
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吴春华 张勇
摘要 目的：探讨手术治疗先天性巨输尿管症的时机和有效性。方法：总结本病10例，其中男6例，女4例；儿童4例，成人6例；左侧4例，右侧2例，双侧4例。保守治疗1例；手术治疗9例，包括输尿管剪裁整形再植术5例，肾输尿管全切术4例。结果：9例获随访3个月～6年。4例患儿发育正常，健肾代偿性增大。双侧者术侧肾、输尿管积水减轻，症状明显缓解，保守侧无显著变化。结论：儿童患者应尽早手术治疗，成人患者可根据病变情况采用保守或手术治疗。
关键词 先天性巨输尿管 泌尿外科手术 输尿管再植术
Congenital megaureter(Report 10 Cases)
Wu Chunhua Zhang Yong
(Department of Urology,the Affiliated Hospital of Ningxia Medical
College,Yingchuan,750004)
Abstract Purpose:To study the timing and efficacy of the surgery for the treatment of congenital megaureter.Methods:Between May 1986 and Jan 1998,10 patients with congenital megaureter were treated.Among them,6 cases are male and 4 female,4 children and 6 adults,left side 4 cases,right side 2 and bilateral 4. Surgical route was adopted in 9 patients,in which 5 cases underwent ureteroplasty reimplantation;4 cases nephroureterectomy,and 1 patient was given a long-term observation.Results:All 9 petients were followed-up from 3 months to 6 years.4 children had a normal growth.There were enlargement in their remained healthy kidneys.They were found that the hydronephrosis and hydroureter of the operated side of the patients with bilateral disorder had reduced and the symptoms of the patients with bilateral disorder had reduced and the symptoms of the patients relieved.There were no significant change on the none-operated side.Conclusions:The children patients should receive surgical treatment earlier.The adult patients can be viewed or receive surgical treatment if nesessary.
Key words Congenital megaureter Urologic surgery Ureter reimplantetion
先天性巨输尿管症是临床上较为少见的输尿管疾病，以输尿管末端功能性梗阻、输尿管显著扩张为特征。临床上以尿路感染、血尿、腰痛和腹部包块为主要表现。我院1986年5月～1998年1月收治10例，报告如下。
1 资料与方法
1.1 临床资料
男6例，女4例。儿童4例，年龄5个月～8岁；成人6例，年龄20～43岁。左侧4例，右侧2例，双侧4例以右侧为重。3例儿童合并患侧肾发育不良(其中1例伴右侧隐睾)。临床表现：腰腹部胀痛3例，尿路感染伴发热2例，间歇性肉眼血尿2例，腹部囊性包块1例。体检发现2例。病史1周～5年。
实验室检查：尿常规提示脓尿3例、血尿2例。10例B超检查，提示患侧肾发育不良、积[1] [2] 下一页
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