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对下尿路有严重异常而又需要做肾移植的病人,以往都是采用异位肾移值和游离肠袢尿液分流术。而本文作者为一例下尿路有严重异常的终未期肾衰病人做了原位肾移植和回肠尿路重建及尿流改道手术,取得良好效果。病人,男,29岁,其肾衰系继发于骶内脊髓膜突出所致的膀胱括约肌功能障碍。10岁时,做了双侧输尿管经皮造口术。在肾移植前,因持继性尿路感染而行右肾切除。X光检查和尿流动力学测定提示下尿路功能不良,不能用于肾移植。逐于82年8月做了回肠尿路重建及经皮造口术。手术过程:脐下正中切口。游离未段回肠20cm,切除10—20cm肠段。吻合回肠。将游离肠段垂直位放在髂窝回肠吻合口后方。肠段的蠕动方向应由上向下。然后,
There are serious abnormalities in the lower urinary tract but need to do kidney transplant patients, the past are the use of ectopic renal transplant value and free intestinal loop urine shunt. The author of this article for a case of lower urinary tract abnormalities have not yet end-stage renal failure patients underwent renal transplantation and ileal urinary tract reconstruction and urinary diversion surgery, and achieved good results. Patient, male, 29 years old, whose renal failure is secondary to sacral sphincter dysfunction due to prominence of the sacral spinal membranes. At the age of 10, bilateral ureteral percutaneous ostomy was done. Right before kidney transplantation, right nephrectomy was performed due to a persistent urinary tract infection. X-ray examination and urodynamic assessment suggest that urinary tract dysfunction, can not be used for kidney transplantation. By August 82, I have done ileal urinary tract reconstruction and percutaneous ostomy. Surgical procedure: median incision under the navel. Free segment ileum 20cm, removal of 10-20cm intestinal segment. Anastomosis ileum. The vertical position of the free bowel will be placed behind the anastomotic iliac fossa. Intestinal motility should be from the top down. then,