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目的探讨小儿输尿管息肉致梗阻性肾积水的临床特点及诊治方法。方法回顾分析1987~2005年收治33例小儿输尿管息肉致梗阻性肾积水的临床资料,男32例,女1例,左侧27例,右侧5例,双侧1例。就诊年龄5~14岁,平均9岁,病程1个月至5年,平均1年7个月,发病年龄4~12岁,平均7岁。结果33例患儿行手术治疗,手术及术后病理证实肾脏积水为输尿管息肉造成梗阻所致,术后6~12个月行IVP检查,肾积水缓解或减轻,腹痛症状消失,随访6个月至18年未见息肉复发。结论输尿管息肉致梗阻性肾积水以男孩多见,且以学龄儿童为主,多发生在左侧,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。治疗根据息肉的位置及大小决定手术方案,包括息肉段输尿管切除+肾盂输尿管吻合,及息肉段输尿管切除+输尿管-输尿管吻合。
Objective To investigate the clinical features and diagnosis and treatment of obstructive hydronephrosis caused by ureteral polyps in children. Methods The clinical data of 33 cases of obstructive hydronephrosis caused by ureteral polyps in 1987 ~ 2005 were analyzed retrospectively. There were 32 males and 1 females, 27 cases on the left, 5 cases on the right and 1 case on both sides. Aged 5 to 14 years old, an average of 9 years old, duration of 1 month to 5 years, an average of 1 year and 7 months, the age of onset of 4 to 12 years old, with an average of 7 years. Results 33 cases of children underwent surgical treatment, surgery and postoperative pathology confirmed renal hydronephrosis caused by ureteral polyps caused by obstruction, 6 to 12 months after IVP examination, hydronephrosis alleviate or reduce the symptoms of abdominal pain disappeared, followed up 6 No recurrence of polyps between months and 18 years. Conclusions Ureter polyps induced obstructive hydronephrosis is more common in boys, and mainly in school-age children, mostly in the left side, clinical manifestations and other causes of hydronephrosis similar, but more severe abdominal pain, hydrocephalus and more. Treatment based on the location and size of the polyps determine the surgical options, including polyps ureteropelvic ureteropelvic anastomosis, and polyps ureteral resection + ureter-ureter anastomosis.