回肠代输尿管术治疗小儿重度肾积水疗效观察

为探讨回肠代输尿管术治疗小儿重度肾积水的疗效，采用回肠代输尿管术治疗小儿重度积水２０例，其中双侧肾积水７例，４例采用回肠Ｓ形吻合，３例采用回肠Ｙ形吻合，结果术后并发低血钾性肌病１例，尿路感染２例，经药物治愈；并发粘连性肠梗阻１例，膀胱结石２例，肾肠吻合口狭窄１例，均再手术治愈，随访１￣２５年均获得满意效果，肾功能及形态均较术前明显改善，有３例术后１年发生膀胱回肠返流，但均在Ｌ５模突以下，有１例在术

Replacement of the ureter by ileal segment of the treatment of severe hydronephrosis in children

From Feb. 1970 to Nov. 1995,20 cases with severe hydronephrosis underwent the operation of ileal ureter,of which 17 cases were male and 3 cases were female. Their age ranged from 4 to 15 years with an average of 9. 4 years. After the operation,the hypokalemic myopathy oc curred in 1 case,urinary tract infection in 2 cases,adhesive intestinal obstruction in 1 case,urinary bladder stone in 2 cases,and stenosis of anastomosis between the kidney and intestine in 1 case.These complications were cured by medical or operative methods. All 20 patients have been fol lowed up for 1~25 years,of which 10 cases for more than 10 years. The curative effect was satis factory. The renal function and hydronephrosis were found to be improved markedly by intravenous pyelography. The vesicoileal reflux was found by stand cystogram in 3 of 11 cases,but it was below the level transverse process of the L5.1 case died of virus encephalitis 3 years after the operation.The postoperative urinary tract infection, electrolyte imbalance, vesicoileal reflux and the indica tions of ureteral replacement with ileal segment were discussed.