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目的探讨肾盂输尿管连接部梗阻(UPJO)的临床特点及手术方法。方法回顾性分析65例肾盂输尿管连接部梗阻患者,采用离断式肾盂成形术,术中留置双J管,观察治疗效果。结果 65例均行离断式肾盂成形术,术后2例出现急性肾盂肾炎,抗感染治疗后恢复;1例发生漏尿,通过延长腹膜后引流管留置时间,漏尿消失;1例出现再次狭窄,重新放置双J管后好转。随访6个月～2年,平均16个月,B超或IVU检查患侧肾实质明显增厚,输尿管通畅,肾积水消失49例,轻度肾积水14例,中度肾积水2例;患者泌尿系感染、腹部肿物、腰腹部胀痛不适及肉眼血尿等症状消失。结论离断式肾盂成形术是治疗UPJO的经典标准术式,引流可靠,并发症少,费用低,疗效确切。
Objective To investigate the clinical features and surgical methods of ureteropelvic junction obstruction (UPJO). Methods A retrospective analysis of 65 cases of ureteropelvic junction obstruction in patients with segmental pyeloplasty, intraoperative double J tube indwelling to observe the therapeutic effect. Results All the 65 patients underwent pyeloplasty. Two patients had acute pyelonephritis after operation, and recovered after anti-infective therapy. One patient had leakage of urine and the leakage of urine disappeared by prolonging the dwell time of retroperitoneal drainage tube. One patient appeared again Narrow, reposition double J tube improved. All the patients were followed up for 6 months to 2 years with an average of 16 months. The parenchyma of the ipsilateral kidney was significantly thicker with B-ultrasound or IVU, ureter was patency, hydronephrosis disappeared in 49 cases, mild hydronephrosis in 14 cases, Cases; patients with urinary tract infection, abdominal mass, waist and abdomen discomfort and gross hematuria and other symptoms disappear. Conclusion Interrupted pyeloplasty is the classic standard surgical treatment of UPJO, reliable drainage, fewer complications, low cost and effective curative effect.