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目的:探讨在Anderson Hynes手术中不留置肾造瘘管及输尿管支架管,仅留置肾周引流管的安全性、可行性及手术效果。方法:在对42例先天性肾盂输尿管连接处狭窄(UPJO)患儿实施Anderson-Hynes手术时,不留置肾造瘘管及输尿管支架管,仅留置肾周引流管。根据Grignon肾积水分类标准,42例中3级4例,4级31例,5级7例。结果:37例术后7天拔除肾周引流管;2例分别于术后8、11天肾周引流管无尿液引流并持续3天,拔除引流管;3例术后14天夹管观察2天,无异常拔除引流管。术后1、3、6个月行尿常规检查及B超检查,4例尿路感染,经抗感染等而治愈;全部病例肾积水无加重、肾皮质增厚。结论:有选择地对部分UPJO病例实施Anderson-Hynes手术时,不留置肾造瘘管及输尿管支架管,仅留置肾周引流管可以缩短住院时间、减轻患者的经济负担、减少与引流相关的并发症,是安全、可行、有效的。
Objective: To investigate the safety, feasibility and operative effect of indwelling renal drainage tube in Anderson Hynes operation without indwelling renal fistula and ureteral stent. Methods: Anderson-Hynes procedure was performed in 42 children with congenital ureteropelvic junction stenosis (UPJO). Renal fistulas and ureteral stents were not placed, only the perirenal drainage tube was placed. According to the classification criteria of hydronephrosis of Grignon, 42 cases were grade 3 in 4 cases, grade 4 in 31 cases and grade 5 in 7 cases. RESULTS: Thirty-seven patients had peritoneal drainage tube removed 7 days after operation. There were no drainage of the perirenal drainage tube for 3 days after operation in 8 and 11 days after operation, respectively. 2 days, no abnormal removal of drainage tube. Urine routine examination and B-ultrasound were performed at 1, 3, and 6 months after operation. Urinary tract infection in 4 cases was cured by anti-infection. No renal hydronephrosis and thickened renal cortex were found in all cases. CONCLUSIONS: Anderson-Hynes procedure can be selectively performed in selected UPJO cases without nephrostomy tubes and ureteral stent grafts, and indwelling only the perirenal drainage tube can shorten the length of stay, reduce the financial burden on patients, and reduce the complications associated with drainage It is safe, feasible and effective.