小儿肾盂输尿管连接部梗阻采用腹部微创小切口治疗的效果观察

雷普

（榆林市第二医院泌尿外科，陕西 榆林，719000）

浏览次数：117次 下载次数：308次

摘要：

目的 探讨小儿肾盂输尿管连接部梗阻通过腹部微创行离断式肾盂成形术治疗的临床疗效。方法 回顾性分析2013年12月至2015年12月在我院采用腹部微创小切口、腹膜外入路行离断式肾盂成形术治疗的小儿肾盂输尿管连接部梗阻33例患儿的临床资料，对其手术指标、临床效果及并发症发生情况进行总结。结果 33例患儿手术均成功，平均手术时间为（89.0±37.0）min，平均出血量为（16.0±12.0）mL，术后随访3~12月，伤口均愈合良好，无吻合口狭窄、尿瘘、泌尿系感染等并发症，所有肾盂均有不同程度缩小，肾实质增厚。结论 采取腹部微创小切口行离断式肾盂成形术治疗小儿肾盂输尿管连接部梗阻，效果确切，值得临床推广应用。 

关键词：肾盂输尿管连接部梗阻；肾盂积水；腹部微创小切口；离断式肾盂成形术

中图分类号：R726.9 文献标志码：A文章编号：2096-1413(2017)14-0149-02

Effect observation of minor abdominal incision on children with urete pelvic junction obstruction
LEI Pu
(Department of Urology, the Second Hospital of Yulin, Yulin 719000, China)

ABSTRACT: Objective To assess the clinical effect of minor abdominal incision in dismembered Anderson -Hynes pyeloplasty in the treatment of ureter pelvic junction obstruction (UPJO) on children. Methods Retrospective analysis was carried out on the data of 33 children with UPJO treated with minor abdominal incision in dismembered Anderson-Hynes pyeloplasty from December 2013 to December 2015. The operating indexes, clinical effect and operation complications were collected and reviewed retrospectively. Results Operations were all successful on 33 children. The mean operation time was (89.0±37.0) min, and the mean blood loss was (16.0±12.0) mL. All the children were followed up for 3 to 12 months, the wound healed well, no anastomotic stenosis, urethral fistula, urinary infection were found, hydronephrosis was remitted and renal functions were improved. Conclusion Minor abdominal incision in dismembered Anderson-Hynes pyeloplasty is an effective and safe way in the treatment of UPJO in children, which is worthy of clinical application.
KEYWORDS: ureter pelvic junction obstruction; hydronephrosis; minor abdominal incision; Anderson-Hynes pyeloplasty

参考文献：
[1] NGUYEN HT,KOGAN BA.Upper urinary tract obstruction: experimental and clinical aspects[J].Br J Urol,2015,81(S2):13-21.
[2] O`REILLY PH,BROOMAN PJ,MAK S,et al.The long-term results of Anderson-Hynes pyeloplasty[J].BJU Int,2014,87(4):287-289.
[3] 张忠昇.离断性肾盂成形术治疗小儿肾盂输尿管连接部狭窄21例[J].临床泌尿外科杂志.2005,20(11):701-703.
[4] 孙劲松,林涛,魏光辉,等.离断性肾盂成形术治疗先天性肾盂输尿管连接部梗阻[J].临床小儿外科杂志,2009,8(6):38-40.
[5] 吴中华,齐范,余建华,等.小儿后腹腔镜下离断性肾盂成形术[J].中华泌尿外科杂志.2010,31(7):29-30.
[6] 吴荣德,于启海,马睿,等.腹腔镜在小儿离断性肾盂成形术中的应用[J].中华小儿外科杂志,2014,29(1):50-52.
[7] 毕允力,阮双岁,陆良生,等.单切口腹腔镜肾盂成形术治疗小儿肾盂输尿管连接部梗阻[J].中华小儿外科杂志,2014,32(1):16-18.