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本组先天性肾盂积水患者20例,其中男12例,女8例;年龄6个月至4岁;病史2个月至2年,左侧14例,右侧6例。均以腹部包块就诊。静脉肾盂造影均示患侧肾脏不显影、输尿管不显示。尿常规无异常。B超示肾盂积水、肾皮质变薄。手术方式:均行肾盂部分切除+肾盂输尿管成形术,术后放置支架管及肾造瘘管。术中见肾盂输尿管连接部狭窄12例,迷走血管压迫6例,输尿管扭曲成角畸形2例。肾皮质0.5cm以上16例,0.3～0.5cm3例,<0.3cm1例。肾盂容量500～1200ml。术后患肾引流量300～500ml/d,造影示吻合口通畅,但有不同程度的肾盂扩张,肾盏轻度扩大。随访1～5年,患儿发育及小便正常。未发现明显并发症。 讨论:先天性肾盂积水诊断不难,腹部包块多位于积水一侧,无明显压痛,边界清楚,合并泌尿系感染者可有发热、尿频、尿痛等症状。B超及IVP检
The group of 20 patients with congenital hydronephrosis, including 12 males and 8 females; aged 6 months to 4 years old; history of 2 months to 2 years, 14 cases on the left and 6 cases on the right. All abdominal mass treatment. Intravenous pyelography showed ipsilateral kidney does not develop, ureter does not show. No abnormal urine. B ultrasound showed hydronephrosis, renal cortical thinning. Surgical methods: partial renal pelvis resection + ureteropelvic angioplasty, stent placement and renal fistula postoperative. Intraoperative see ureteropelvic junction stenosis in 12 cases, vagus vascular compression in 6 cases, ureter distorted angular deformity in 2 cases. Kidney cortex 0.5cm above 16 cases, 0.3 ~ 0.5cm3 cases, <0.3cm1 cases. The renal pelvis capacity 500 ~ 1200ml. Postoperative renal drainage 300 ~ 500ml / d, angiography showed anastomotic patency, but with varying degrees of renal pelvis expansion, mild expansion of the kidney. Follow-up 1 to 5 years, children with normal urination and development. No obvious complications were found. Discussion: Congenital hydronephrosis is not difficult to diagnose, abdominal mass is located in the side of the hydrocephalus, no significant tenderness, the border is clear, with urinary tract infection may have fever, frequent urination, dysuria and other symptoms. B-and IVP inspection