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目的 :探讨腔静脉后输尿管的诊治方法。方法 :对 8例的临床资料进行回顾分析。术前检查采用IVP和逆行输尿管插管造影 ,1例加用了presman法。术前诊断根据本病的典型X线表现获得并被手术证实。行下腔静脉后狭窄的输尿管切除匙形吻合术 7例 ,行输尿管切断斜行吻合术 1例。结果 :术后第 3周拨支架管并经肾造瘘管行肾盂输尿管造影 ,7例切除狭窄的输尿管者 ,造影剂顺利通过输尿管 ;未切除狭窄的输尿管者 ,至术后第四周造影剂才通过输尿管。随访 1～ 4年 ,狭窄的输尿管切除者 ,肾积水基本消失 ;狭窄段未切除者 ,肾积水明显减轻。所有病人症状未再发。结论 :逆行输尿管插管造影是诊断本病的首选方法。切除狭窄段输尿管对本病的治疗具有重要作用 ,输尿管吻合宜采用匙形吻合。
Objective: To investigate the diagnosis and treatment of ureter after vena cava. Methods: The clinical data of 8 cases were retrospectively analyzed. Preoperative examination using IVP and retrograde ureteral catheterization, 1 case plus presman method. Preoperative diagnosis based on the typical X-ray findings of the disease was confirmed by surgery. Seven cases underwent ureteral resection key anastomosis after inferior vena cava stenosis and one case underwent ureteral incision oblique anastomosis. Results: In the third week after operation, the renal pelvis and ureter were placed in the stent tube and the renal pelvis and ureter were performed in the third week. The stenosed ureter was removed in 7 cases and the contrast agent passed through the ureter smoothly. In the fourth week after operation, Through the ureter. Follow-up 1 to 4 years, the narrow ureter resection, hydronephrosis disappeared; stenosis were not removed, hydronephrosis significantly reduced. All patients had no recurrence of symptoms. Conclusion: retrograde ureteral catheterization is the preferred method of diagnosis of the disease. Removal of the narrow segment of the ureter on the treatment of the disease has an important role in ureteral anastomosis should be used spoon-shaped anastomosis.