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目的探讨肾盏憩室去顶术后漏尿的治疗方法及预防措施。方法选择2003年至2013年我院收治的8例术后漏尿的患者,术前均误诊为肾囊肿,术后证实为肾盏憩室。在逆行插入D-J管的基础上,1例漏尿自然愈合;7例行手术治疗,其中1例采取微创顺行切开扩大憩室颈的方法,4例行开放手术,2例行腹腔镜手术,术中缝合憩室颈开口,灼烧憩室腔黏膜。结果所有患者漏尿均愈合,患者无发热,无腰痛,B超显示患肾周围无积液,其中6例憩室完全消失,2例可见憩室较术前明显减小。结论肾盏憩室行去顶减压后出现的漏尿不易自行愈合,应采用手术治疗,预后较好。而术前正确诊断肾盏憩室是减少术后漏尿的关键。
Objective To investigate the treatment of leakage of calyceal diverticulum to the top and the preventive measures. Methods Eight patients with postoperative leakage of urine collected from 2003 to 2013 in our hospital were randomly diagnosed as renal cysts before operation and confirmed as calyceal diverticulum after operation. On the basis of retrograde insertion of DJ tube, one case of leakage of urine naturally healed; seven cases of surgical treatment, including one case of minimally invasive method to expand the diverticulostomy straight neck, 4 cases of open surgery, 2 cases of laparoscopic surgery Intraoperative suture diverticulum neck opening, burning diverticulum lumen mucosa. Results All patients had leakage of urine, no fever and no lumbago. Ultrasonography showed no effusion around the kidneys, of which 6 cases had diverticulum disappeared completely. The diverticulum was significantly reduced in 2 cases. Conclusions Renal calculus diverticulum line to top and decompression after the leakage of urine is not easy to heal, surgery should be used, the prognosis is good. Preoperative correct diagnosis of calyceal diverticulum is the key to reducing postoperative leakage of urine.