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目的 :探讨肾盂输尿管连接部梗阻的最佳治疗方案及引流方式。方法 :报告 63例 ( 70侧 )肾盂输尿管连接部梗阻病人 ,48侧行 Anderson- Hynes肾盂成形术 ,6侧行肾盂瓣输尿管成形术 ,5例行 Y- V成形术 ,1 1例行肾切除术。 8例巨大及重度肾积水病人在 A- H肾盂成形术基础上加肾内翻折叠及肾固定术 ,所有病人均放置输尿管支架引流。1 1例儿童病人应用改良式双 J管内引流。结果 :48侧 A- H肾盂成形术病人术后复查肾盂明显缩小 ,肾功能改善 ,电视动态观察 UPJ处蠕动良好。6侧肾盂瓣输尿管成形术及 5侧 Y- V成形术术后复查肾积水有改善 ,肾盂缩小不明显 ,UPJ处蠕动幅度、频率改善不明显。结论 :A- H肾盂成形术为最佳术式 :巨大肾积水 A- H肾盂成形术加肾内翻折叠及肾固定术不仅改善外观 ,更利于引流及功能的恢复。改良后的双 J管也可用于儿童患者内引流。
Objective: To investigate the best treatment and drainage of ureteropelvic junction obstruction. METHODS: Sixty-three (70) ureteropelvic junction obstruction patients were reported. Anderson-Hynes pyeloplasty was performed on 48 sides, ureteroplasty on 6 sides, Y-V plasty on 5 sides, and nephrectomy on 11 Surgery. Eight patients with massive and severe hydronephrosis were treated with A-H pyeloplasty and renal nephrolithotomy. All patients underwent ureteral stent drainage. 1 1 cases of children with modified double J tube drainage. Results: 48 patients with A-H pyeloplasty postoperative review of the renal pelvis was significantly reduced renal function improved dynamic TV UPJ Department of peristaltic good. 6 side renal pelvis ureteroplasty and 5 side Y-V plasty postoperative hydronephrosis improved, renal pelvis was not obvious, UPJ Department of creep amplitude, frequency was not significantly improved. CONCLUSIONS: A-H pyeloplasty is the optimal procedure: A-H pyeloplasty and nephrostomy and nephrectomy not only improve appearance but also facilitate drainage and functional recovery. Improved double J tube can also be used for drainage of pediatric patients.