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目的:探讨先天性肾盂输尿管连接部梗阻的治疗方法。方法:113例先天性肾盂输尿管连接部梗阻的患者 ,84例采用 Anderson- Hynes术式治疗 ;17例肾下极异位血管压迫造成的肾盂输尿管连接部梗阻 ,采用血管束悬吊或肾盂下端切断重吻合治疗 ;12例行肾切除。结果 :113例术后随访 3个月～ 5年。异位血管压迫造成梗阻的17例均经手术治愈 ;Anderson- Hynes术式治疗的 84例中 10例吻合口再狭窄 ,3例手术重吻合治愈 ,4例腔内扩张治愈 ,3例肾功能丧失或继发感染切除病肾 ;其余 12例肾切除后治愈。结论:Anderson- Hynes术式是治疗先天性肾盂输尿管连接部狭窄的首选方法 ;异位血管的悬吊移位或肾盂切断重吻合是治疗异位血管压迫造成肾积水的首选方法。
Objective: To explore the treatment of congenital ureteropelvic junction obstruction. Methods: 113 patients with congenital ureteropelvic junction obstruction in 84 patients with Anderson-Hynes surgical treatment; 17 cases of inferior renal pelvic ureteropelvic junction obstruction caused by vascular bundle suspension or lower pelvis Re-anastomosis treatment; 12 cases of nephrectomy. Results: 113 cases were followed up for 3 months to 5 years. Eighteen cases of obstruction caused by ectopic vascular compression were cured by surgery. Among 84 cases treated by Anderson-Hynes operative procedure, 10 cases were anastomotic restenosis, 3 cases were cured by anastomosis, 4 cases were cured by intracavitary dilatation and 3 cases were with loss of renal function Or secondary infection of diseased kidney; the remaining 12 cases were cured after radical nephrectomy. Conclusions: Anderson-Hynes procedure is the preferred method for the treatment of congenital ureteropelvic junction stenosis. Ectopic vascular suspensions or pelvic resection and anastomosis are the preferred methods to treat hydronephrosis caused by ectopic vascular compression.