摘要
目的:探讨先天性巨输尿管症的疾病特点、诊断、治疗及预后情况,提高对先天性巨输尿管的诊疗水平。
方法:回顾性分析我院从1990年1月-2004年12月收治的35例先天性梗阻性巨输尿管患者的临床资料并进行随访研究,复习相关文献。
结果:本组35例患者,男20例、女15例。患者年龄从分布12岁-66岁,平均年龄为32.6岁。35名患者中左巨输尿管17例,右巨输尿管11例,双侧巨输尿管7例。先天性输尿管膀胱连接部狭窄3例,输尿管末段闭锁1例,输尿管末段功能性梗阻31例。本组35例患者以腹部和腰部疼痛为首发症状的21例(60%),以血尿为首发症状的5例(14.2%),无明显症状、体检时发现9例(25.8%)。35例患者入院后全部行B超,静脉或逆行尿路造影检查,发现35例患者输尿管不同程度扩张。35例患者中有1例患者因泌尿系统感染,肾功能严重损害,行抗感染治疗后自动出院。34例患者接受手术治疗,2例行患侧肾脏输尿管切除术,余32例患者行输尿管膀胱再植术。有12例患者得到随访,患者随访时间最长105个
Objective:Study the character ,diagnosis and therapy of primary obstructive megaureter, to elevate the methods of diagnosis and treatment of primary obstructive megaureter.Methods:The data base record of 35 primary obstructive megaureter patients treated between January 1990 and December 2004 in Uroloral department of West china Hospital and the literature of megaureter was reviewed.35 patient gender,age,clinic presention,loction of lesion,diagnosisi,treatment was ananlysed.Result: Our study 35 sample comprised of 20 men and 15 women,with an average age of 32.6(range 12-66year).17 patients were left megaureter ,11 were right ,and 7 were bilateral.3 were primary ureterovesical junction stricture, 1 was ureterovesical junction atresia,and 31 were functional obstruction of the end ureter. Pain was the most common complaint(60%),5(14.2%)of them first complaint were heama urine ,and 9 of the patient were asymptom .2 patient underwent unilateral ureter and kidney resected ,32 patient underwent ureterovesical reimplantation. And there are 12 patinet follow up result from 4 to 104 month ,average 56month.Renal
function of 12 patient were stable,and the average diameter reduce form1.76cm to 0.8cm.Conclusion :IVP was the most impotant method to diagnosis primaryobstructive megaureter.Ureter tailor and ureterovesical reimplantation is theeffective treatment to adult patient, but the style of the surgery should bestudied more.
引文
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