先天性肾盂输尿管连接部梗阻的诊断治疗

目的 探讨小儿先天性肾盂输尿管连接部梗阻（UPJO）致肾积水诊断和治疗的最佳方法。方法 对26例小儿UPJO致重度肾积水，采用B超与静脉尿路造影（IVU）相结合的诊断方法和离断式肾盂输尿管成形术（Anderson—Hynes手术）治疗，总结其效果。结果 所有病例经手术和病理检查证实诊断正确，手术经过顺利，术后恢复好。24例获随访6个月～2年，无血尿、尿频、腹部包块、腹胀等症状，尿常规正常，临床治愈。B超示扩张的肾较术前缩小、肾实质厚度增加；IVU示手术侧肾显影时间提前、杯口形态改善，其中20例输尿管显示良好。结论 B超和IVU相结合是诊断小儿UPJO极有效的方法；Anderson—Hynes手术是治疗UPJO的最佳术式。

Diagnosis and Treatment of Ureteropelvic Junction Obstruction in Children

Objective To explore the best way to diagnose and cure the nephrosis with ureteropelvic junction obstruction(UPJO) in children.Methods The diagnosis of 26 cases of nephrosis with UPJO were confirmed by ultrasonogram and IVU examinations.All patients underwent AndersonHynes procedures.These results were analyzed and summarized.Results All the diagnosis were proved to be correct by operation and pathology examinations,the operations were carried out successfully.Twenty-four cases were followed up for 6 months to 2 years.After the operation,the hematuria,urinary frequency,abdominal mass and distention disappeared,the urine analysis was normal,all cases cured clinically.Ultrasonogram examinations showed the thickness of parenchyma increased and the large kidneys lessened.Significantly improved renal fuoction on IVU examinations was observed in the 24 cases compared with that before the operations.The ureters of 20 cases displayed well.Conclusions The combination of ultrasonogram and IVU is very effective method to diagnose UPJO in children.Anderson-Hynes technique is the best procedure to cure the UPJO.