先天性异位肾伴输尿管开口异位的诊断和治疗(附7例报告)

目的探讨先天性异位肾伴输尿管开口异位的诊断和外科治疗。方法回顾性分析7例异位肾伴输尿管异位开口的临床症状和体征及外科治疗方法。结果7例中6例有漏尿病史，1例腹部可扪及包块，1例可见输尿管异位开口，6例美蓝试验阳性。影像学检查中B超发现4例发育不良的异位肾，IVU检查有3例异位肾显影，可见输尿管行程，CT、CT增强检查可定位7例异位肾和输尿管的位置。外科治疗中行输尿管膀胱再植手术5例，肾切除手术1例，保守治疗1例。术后随访0．5—7年肾功能均有不同程度的改善，漏尿症状消失，无肾积水。结论典型的病史、仔细的体查结合美蓝试验、IVU检查是诊断的基础，B超可作为筛选手段，CT、CT增强可作为常规的确诊检查。外科手术是治疗异位肾伴输尿管异位开口的主要方法。

Diagnosis and Treatment of Congenital Ectopic Kidney With Ectopic Opening of Ureter (Report of 7 cases)

Objective To study the diagnosis and treatment of congenital ectopic kidney with ectopic opening of ureter. Methods Of the symptom and sign and physics determination and surgical treatment were reviewed for 7 cases of congenital ectopic kidney with ectopic opening of ureter. Results 6 of 7 cases keeping on leaking of urine. abdominal mass of one case was touched.A ectopic opening of ureter of one case was found. Methylene blue test of 6 cases was positive. 4 dysplastic ectopic kidney were detected by B-US.3 ectopic kidney and tracks of ureter were developed in IVU examination. The position of 7 ectopic kidneys was confirmed. By imaging of CT and augmentive CT,5 cases were managed by ureteroneocystostomy. One case was nephrectomized. Conservative treatment was used for one case. All cases were followed for 0.5-7 years.All renal function tests were improved at the differenfial degree. Leakage of urine and hydronephrosis were not found. Conclusions The typical history and careful somatoscopy and methylene blue test are the bases of diagnosis. BUS can be used as a screening measure. IVU and CT and augmentive CT can be used as a clear-definite diagnosis. Surgical operation is the major treatment of ectopic kidney with ectopic opening of ureter.