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目的探讨肾盂输尿管连接部梗阻的手术治疗方法技巧和临床效果。方法回顾分析45例肾盂输尿管连接部梗阻患者的临床资料。其中肾盂输尿管连接部狭窄32例,迷走神经压迫6例,纤维条索压迫4例,肾盂输尿管高位连接3例;行离断性肾盂成形术30例,非离断性肾盂成形术12例,肾切除术3例。结果本组45例随访6～48个月,平均24个月。30例离断性肾盂成形术中,有29例(96.7%)肾积水消失或明显减轻,1例无明显变化;12例非离断性肾盂成形术中,9(75.0%)例肾积水减轻,2例肾积水无明显变化,1例肾积水加重。结论离断性肾盂成形术是治疗肾盂输尿管连接部梗阻的首选术式。
Objective To investigate the surgical treatment methods and clinical effects of ureteropelvic junction obstruction. Methods Retrospective analysis of 45 cases of renal pelvis and ureter obstruction in patients with clinical data. The ureteropelvic junction stenosis in 32 cases, vagus nerve compression in 6 cases, 4 cases of fibrous cord compression, high ureteropelvic junction in 3 cases; line disconnection pyeloplasty in 30 cases, non-interrupted pyeloplasty in 12 cases, nephrectomy Surgery in 3 cases. Results The group of 45 patients were followed up for 6 to 48 months, an average of 24 months. Thirty-nine patients (96.7%) had hydronephrosis disappeared or significantly reduced in one of the 30 cases, with no significant change in one of the 12 cases. Of the 12 nonparenchymal pyeloplasty patients, 9 (75.0% Water relief, 2 cases of hydronephrosis no significant change, 1 case of hydronephrosis aggravated. Conclusion Intermittent pyeloplasty is the first choice for the treatment of ureteropelvic junction obstruction.