脊髓栓系综合征致上尿路积水的手术疗效观察

目的　探讨脊髓栓系综合征 (TCS)引起上尿路积水去栓手术的疗效。　方法　对 2 0例TCS伴有上尿路积水患者进行去栓手术 ,观察比较手术前后膀胱剩余尿、肾和输尿管积水、肾皮质厚度及肾功能的变化。　结果　膀胱剩余尿恢复正常 5例 ,减少 10例 ,总有效率 83%。肾积水明显减少 6例 ,轻度减少 7例 ,无改变 7例 ,总有效率 6 5 %。输尿管积水明显减少 7例 ,好转 4例 ,无变化7例 ,总有效率 6 1%。肾皮质厚度明显增加 5例 ,轻度增加 2例 ,无改变 13例 ,总有效率 35 %。肾功能中度尿毒症转为轻度 2例 ,轻度转为正常 4例 ,14例同术前正常。　结论　去栓手术治疗TCS伴发上尿路积水和尿毒症有效。

Detethering operation for hydrops of upper urinary tract caused by tethered cord syndrome

Objective To investigate the result of detethering operation for the hydrops of upper urinary tract caused by tethered cord syndrome (TCS). Methods A retrospective study was carried out on 20 cases of TCS treated by detethering operation. The main parameters were compared pre-and postoperation on postvoiding residual volume, kidney and ureter of B-ultrasonograph and renal function of serum biochemicals. Results The postvoiding volume resumed normal in 5 cases,decreased in 10 cases.The effective rate was 83%.The hydronephrosis was obviously improved in 6 cases,mild in 7 cases and unchanged in 7 cases.The rate of improvement was 65%.The hydroureterosis was markedly effective in 7 cases,partial in 4 cases,unchanged in 7 cases.The rate of effect was 61%.Renocortical thickness was evident increase in 5 cases,alleviate increase in 2 cases and unchanged in 13 cases.The rate of increase was 35%.2 cases of moderate uremia was transformed to mild and 4 cases of mild uremia was changed to normal. Conclusions The detethering operation is rational and effective for hydrops of upper urinary tract and uremia caused by TCS.