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目的 总结下腔静脉后输尿管的诊治经验。 方法 对 2 1例下腔静脉后输尿管患者的症状、影像学检查、治疗和随访情况进行回顾性分析。 结果 以右腰酸痛为主要症状者 2 0例 ,其中 4例有典型肾绞痛 ,8例有肉眼血尿及肾盂结石 ;无症状者 1例。诊断主要依靠IVU及逆行输尿管肾盂造影 ,特征为上段输尿管呈S形扩张。 1例保守治疗 ,2 0例行输尿管复位矫形术。术后随访 2个月～ 2 8年 ,平均 13年 ,19例症状消失 ,肾积水明显减轻 ,1例因吻合口狭窄再次手术。 结论 对不明原因的右肾及上段输尿管积水者应考虑有本病的可能 ,顺、逆行尿路造影是主要诊断依据 ,输尿管复位矫形术可获得良好疗效。
Objective To summarize the diagnosis and treatment of ureter after inferior vena cava. Methods 21 cases of inferior vena cava ureter patients with symptoms, imaging examination, treatment and follow-up were retrospectively analyzed. Results 20 cases were diagnosed as the main symptom of right backache pain, 4 cases had typical renal colic, 8 cases had gross hematuria and renal pelvis, and 1 case had no symptom. Diagnosis mainly depends on IVU and retrograde ureteroscopy, characterized by S-shaped dilatation of the upper ureter. 1 case of conservative treatment, 20 cases of ureteral reduction orthopedic surgery. The patients were followed up for 2 months to 28 years, an average of 13 years, 19 cases of symptoms disappeared, hydronephrosis was significantly reduced, 1 case reoperation due to anastomotic stenosis. Conclusion For the unexplained right renal and upper ureteral hydronephrosis should consider the possibility of this disease, cis and retrograde urography is the main basis for diagnosis, ureteral reduction orthopedic surgery can obtain good effect.