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目的 提高先天性输尿管瓣膜症的诊治水平。方法 回顾性分析了 13例先天性输尿管瓣膜症患者的临床资料。静脉肾盂造影 (IVP)、逆行肾盂造影 (RGP)、核磁共振尿路成像 (MRU)检查诊断 5例 ,5例通过输尿管镜检查发现并诊断 ,3例手术探查发现。结果 13例患者中 ,行输尿管端端吻合术 3例 ;手术输尿管瓣膜切除 5例 ;输尿管镜下钬激光切除瓣膜 5例。手术均 1次成功 ,术后平均随访 14个月 ,普通肾图或利尿性肾图提示输尿管梗阻解除。患侧肾积水好转 ,肾功能改善。结论 尿路造影为诊断本症的主要方法。输尿管镜下钬激光切除输尿管瓣膜症是一种安全、有效的腔内泌尿外科治疗方法。
Objective To improve the diagnosis and treatment of congenital ureteral valve disease. Methods The clinical data of 13 patients with congenital ureteral valve disease were retrospectively analyzed. 5 cases were diagnosed by IVP, RGP and MRU. 5 cases were diagnosed by ureteroscopy and 3 cases by surgical exploration. Results Among the 13 patients, 3 cases underwent ureteral end-to-end anastomosis, 5 cases underwent ureteral valve resection and 5 cases underwent ureteroscopic holmium laser-assisted resection of the valve. The operation was successful in 1 case. The average follow-up was 14 months after operation. The general nephrogram or diuretic nephrogram showed ureteral obstruction was relieved. Ipsilateral hydronephrosis improved renal function improved. Conclusion Urography is the main method of diagnosis of this disease. Ureteroscopic holmium laser resection of ureteral valvular disease is a safe and effective endovascular treatment.