|
离断性肾盂成形术双J管内引流治疗肾盂输尿管连接部狭窄 |
| |
欧阳时锋 黄循 杨金端
摘要 目的：探讨离断性肾盂成形术双J管内引流治疗肾盂输尿管连接部狭窄的临床疗效。方法：采用离断性肾盂成形术治疗先天性肾盂输尿管连接部狭窄32例共35侧，常规采用双J管作支架内引流，术后1个月拔除双J管，3个月行静脉肾盂造影复查。结果：患肾积水好转，吻合口通畅，尿常规检查无严重尿路感染。结论：离断性肾盂成形术是治疗肾盂输尿管连接部狭窄的有效方法，术中使用双J管能减少术后再狭窄的发生，提高手术的成功率。
关键词 离断性肾盂成形术 肾盂输尿管连接部狭窄 输尿管支架管
Double pigtail catheter used in Anderson-Hynes operation
Ouyang Shifeng Huang Xun Yang Jinrui
(Department of Urology,the Second Affiliated Hospital of Hunan
Medical University,Changsha,410011)
Abstract Purpose:To evaluate the clinical effects of double-pigtail catheter in Anderson-Hynes operation for the treatment of ureteropelvic junction obstruction.Methods:Between July 1991 and December 1997,a total of 32 cases of ureteropelvic junction obstruction had a double pigtail catheter placed who were processed with Anderson-Hynes operation.Every double pigtail catheter was removed in 4～6 weeks after operation.Outcome was evaluated with intravenous pelviureterograghy in 3 months.Results:All obstruction was successfully relieved and no complications were noted at followup.Conclusion:Anderson-Hynes operation is an effective method for the treatment of ureteropelvic junction obstruction.Double pigtail placement during operation can reduce the chance of uroteropelvic junction re-stricture.
Key words Anderson-Hynes operation Stricture ureteropelvic junction Double-pigtail catheler
1991年7月～1997年12月，我院采用离断性肾盂成形术(Anderson-Hynes术)治疗先天性肾盂输尿管连接部狭窄32例共35侧，常规采用双J管作支架内引流，取得较好疗效，报告如下。
1 资料与方法
男27例，女5例。左侧21例，右侧8例，双侧3例。年龄7～45岁，平均23岁。术前经B超及KUB+IVU检查，患肾显影延迟，肾盂中度至重度积水。5例合并有患肾旋转不良，3例合并多发性肾盂结石。
1.2 治疗方法
本组病例均采用离断性肾盂成形，术中切除肾盂输尿管连接部狭窄段及扩张的肾盂部分，输尿管端口纵行剪开约0.8 cm，肾盂成形后与输尿管端口行“网拍样”端端吻合，内置F5～8号双J管内引流。5例年龄小于12岁、合并有肾旋转不良及肾盂结石者同时行肾造瘘，将双J管与造瘘管连接，并矫正肾旋转不良，取出肾盂结石。术中发现3例合并有肾下极迷走血管的压迫，遂将血管旷置于输尿管前方。术前术后常规使用抗生素。术后3～4周经膀胱镜拔除或随肾造瘘管拔除双J管。
2 结果
所有患者切口如期愈合，术后3个月行IVU，显示患肾积水好转，吻合口通畅。尿常规检查无严重尿路感染表现。
3 [1] [2] 下一页
上一个医学论文： 肾移植术后医院尿路感染病原菌及危险期研究
下一个医学论文： 单侧多房性肾囊肿7例报告
|
|
|
|
|
|
|
您现在的位置： 绿色健康网 >> 医学论文 >> 外科论文 >> 正文