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目的探讨儿童马蹄肾合并肾积水的临床特点及诊治方法。方法回顾分析1997～2008年首都医科大学附属北京儿童医院外科收治19例儿童马蹄肾合并肾积水的临床资料。结果19例患儿中男16例,女3例,左侧10例,右侧9例。就诊年龄8个月～16岁,平均年龄7岁。对患儿行手术治疗,手术及术后病理证实迷走血管压迫是造成此类肾脏积水的主要原因。术后6～12个月行静脉注射肾透造影术(intravenous pyelography,IVP)检查,肾积水缓解或减轻,腹痛症状消失,随访6个月至14年未见异常。结论马蹄肾合并肾积水以男童多见,且以学龄儿童为主,临床表现和其他原因引起的肾积水类似,但腹痛较剧烈,积水多不重。治疗多采用离断式肾盂成形术。
Objective To investigate the clinical features and diagnosis and treatment of pediatric horseshide kidney and hydronephrosis. Methods The clinical data of 19 cases of children with horseshide kidney and hydronephrosis admitted to the Beijing Children’s Hospital, Capital Medical University from 1997 to 2008 were retrospectively analyzed. Results There were 16 males and 3 females in 19 cases, 10 on the left and 9 on the right. Treatment age 8 months to 16 years old, with an average age of 7 years old. Surgical treatment of children with surgery and postoperative pathology confirmed vagal vascular compression is the main cause of such kidney water. Intravenous injection of intravenous pyelography (IVP) was performed 6 to 12 months after operation, and the hydronephrosis was relieved or alleviated. The symptoms of abdominal pain disappeared, and no abnormalities were observed after 6 months to 14 years of follow-up. Conclusion Horseshoe kidney and hydronephrosis are more common in boys and are mainly in school-age children. The clinical manifestations are similar to those of hydronephrosis caused by other reasons. However, abdominal pain is more severe and hydrocephalus is less severe. The treatment of more use of interrupted pyeloplasty.