经尿道腔内气囊扩张治疗小儿肾盂输尿管连接部狭窄的研究
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【摘要】 目的：探讨经尿道腔内气囊扩张治疗小儿肾盂输尿管连接部（UPJ）狭窄的临床疗效。方法：选取2012年2月-2014年6月在本院行手术治疗的小儿肾盂输尿管连接部狭窄患儿40例，分为观察组和对照组，每组20例，观察组行经尿道球囊扩张术治疗，对照组行开放性肾盂输尿管交界狭窄整形术治疗。观察两组患儿术中出血量、手术时间、手术成功率、术后住院时间、术后并发症发生情况及术后肾积水复况，并分别于术前及术后测量并计算两组患者患肾的分肾肾小球滤过率。结果：观察组患儿术中出血量、术后住院时间及术后并发症发生情况均明显优于对照组，比较差异有统计学意义（P0.05）；术前两组患儿患肾的分肾肾小球滤过率差异无统计学意义（P>0.05），术后1个月均明显上升，且观察组患儿上升幅度大于对照组，比较差异有统计学意义（P
【关键词】 输尿管狭窄； 儿童； 球囊扩张术； 双J管； 肾功能
【Abstract】 Objective： To evaluate the clinical effect of transurethral balloon dilation treatment for the stenosis of pediatric ureteropelvic junction （UPJ）. Method： 40 children with UPJ stenosis were selected and divided into the observation group and the control group， patients in the observation group were treated by transurethral balloon dilatation therapy， the control group was treated by open plastic surgery of UPJ stenosis therapy.The bleeding volume， operation time， operation success rate， postoperative hospital stay， postoperative complications and postoperative hydronephrosis recurrence of the two groups were observed.The renal GFR of all the children patients was tested and calculated before and after therapy. Result： The bleeding volume， postoperative hospital stay and postoperative complications of the observational group were significantly better than those of the control group，the differences were statistically significant（P0.05）. There were not statistically significant differences in the renal GFR of the two groups before operation（P>0.05）， but significantly increased after therapy， and the observation group rose more than the control group，the differences were statistically significant（P
【Key words】 Ureteral stricture； Children； Balloon dilatation； Double J tube； Renal function
First-author’s address： Boai Hospital of Zhongshan City， Zhongshan 528403， China
doi：10.3969/j.issn.1674-4985.2016.07.006
先天性肾盂输尿管连接部（Ureteropelvic junction， UPJ）狭窄是小儿泌尿科临床诊治中较为常见的疾病之一，可病发于各个年龄段，多见于男性[1]。UPJ狭窄患儿尿流受阻，使肾盂压力升高，进而导致肾盂肾盏明显扩张、肾实质变薄萎缩，若不能及时诊断并给予有效治疗，可逐渐发展为重度肾积水，肾功能严重受损，需切除患侧肾脏[2]。UPJ狭窄治疗的关键在于解除肾盂出口狭窄，改善肾积水[3]。经尿道腔镜下球囊扩张术已广泛应用于治疗成人UPJ狭窄患者，但小儿UPJ狭窄腔内球囊扩张术的研究仍较少。本研究采取经尿道腔内气囊扩张术治疗小儿UPJ狭窄，观察其临床疗效，以评价经尿道腔内气囊扩张治疗小儿UPJ狭窄的可行性。现报道如下。