迷走血管与小儿先天性肾积水因果关系分析

目的探讨肾盂输尿管连接部(UPJ)迷走血管与该处梗阻引起的小儿先天性肾积水的因果关系、选择合理手术方式,提高迷走血管存在的小儿先天性肾积水临床诊治水平.方法回顾性分析了我科1998-2003年收治12例迷走血管存在的小儿肾积水诊断治疗随访情况.结果全部病人经开放手术证实,术后随访无复发.肾盂输尿管连接处管壁病理检查结果显示在有迷走血管存在与无迷走血管存在的小儿先天性肾积水中病理改变基本相同.结论该病中迷走血管存在可能不是引起肾盂输尿管连接部梗阻的始动因素.手术必须在转换盂管交界与迷走血管位置同时行肾盂输尿管成形术,切除病变的肾盂输尿管连接部,病理检查的结果为术式的选择提供了依据.

The analysis of causality of cross segmental renal vessel and congenital hydronephrosis in chirdren

Objective: To investigate the causality of cross segmental renal vessel existing in the ureteropelvic junction(UPJ) and the obstruction of UPJ induced hydronephrosis in children and to select reasonable operational method to improve the level of diagnosis and treatment in this disease. Methods: 12 patients with this disease hospitalized and operated in our department form 1998 to 2003 were reviewed retrospectively of their conditions of diagnosis, treatment and follow-up. Results: All the patients were verified to have this disease in operation and none of them relapsed during 1-2 years postoperative follow-ups. There are not any difference in the pathological changes in the walls of UPJ areas between the children of congenital hydronephrosis with and without crossing segmental vessels. Conclusions: The existence of crossing segmental vessels might not be the only initiating factor in the cause of the obstruction of UPJ in this disease.Not only the transposition of the ureteropelvic junction but also the resection of the narrowing UPJ and the plasty of the renal pelvis and ureter should be dealed with during operation at the same time.The results of pathological detection plays an evidential role in the selection of operational methods.