44例小儿重复肾的诊治分析

目的探讨小儿重复肾的诊断方法和手术技巧，以提高其诊治水平。方法回顾性分析2006年9月至2011年10月经作者手术治疗的44例重复。肾患儿临床资料，其中男性10例，女性34例，年龄1个月至13岁，平均年龄2．2岁。均采用B超、MRU、IVU等相结合的方法进行诊断。均行重复肾及所属输尿管切除术。结果44例患儿术中诊断与术前相符，均经手术治疗痊愈出院。42例获随访，随访时间7个月至5年，3例出现输尿管残端综合征，经手术切除输尿管残端后治愈。1例术后出现残肾断面漏尿，经肾周引流管流出，术后6d漏尿停止，B超检查无肾周积液，拔除引流管后康复出院。其余患儿恢复良好。结论B超、IVU、MRU等相结合是诊断小儿重复肾畸形的主要方法，可确诊重复肾；CTU、VCU对诊断有补充作用。手术切除重复肾是治疗重度积水、扩张重复。肾的主要方法，尽量低位切除重复输尿管、完全切除重复肾、保护残留。肾肾盏及所属正常输尿管是手术成功的关键。

Diagnosis and Operation of Duplex Kidney in Children

Objetive To evaluate the diagnostic and operative methods of duplex kidney in order to improve diagnosis and treatment of this disease. Methods The clinical data of 44 children with duplex kidney in our hospital from september 2006 to October 2011 were retrospectively analyzed , of them 34 cases are female, 10 cases are male;the age ranged from 1 month to 13 years old,mean 2.2 years old. All of the 44 children had undergo B-uhrasonogTaphy,IVU and MRU examinations and heminephroureterectomy. Results All the diagnosis were confirmed correct by operation. 42 cases were followed up for 7 months to 5 years, of which 3 cases had distal ureteric stump（ DUS）, after operation they were recovery. 1 low pole kidney was found retroperitoneal leakage of urine and was recovery after 7 days. The main cases are good condition. Conclusions For diagnosis of ureter and kidney duplication, B-uhrasonography plus IVU and MRU examinations are sufficient. Heminephroureterectomy is the key treatment for severe duplex kidney and ureter.