论文部分内容阅读
为探讨回肠代输尿管术治疗小儿童度肾积水的疗效，采用回肠代输尿管术治疗小儿重度积水20例，其中双例肾积水7例，4例采用回肠S形吻合，3例采用回肠Y形吻合。结果术后并发低血钾性肌病1例，尿路感染2例，经药物治愈；并发粘连性肠梗阻1例，膀胱结石2例，肾肠吻合口狭窄1例，均再手术治愈。随访1～25年均获得满意效果，肾功能及形态均较术前明显改善，有3例术后1年发生膀胱回肠返流，但均在L5横突以下，有1例在术后3年死于病毒性脑炎。认为回肠代输尿管术是一种较好的保肾术式，适合于输尿管长段病变、巨输尿管症、重度肾积水、成形术失败及伴有复发性结石者等；只要正确对待尿路感染、电解质紊乱及膀胱回肠返流等并发症，均可取得满意效果。
In order to explore the efficacy of ileal ureter in the treatment of hydronephrosis in children, 20 cases of severe hydrocephalus were treated with ileal ureter, including 7 cases of double hydronephrosis, 4 cases of ileal sigmoid anastomosis, 3 cases of ileum Y-shaped anastomosis. Results One case of hypokalemic myopathy and 2 cases of urinary tract infection were cured by drug. One case of adhesive intestinal obstruction, two cases of bladder stone and one case of renal and intestinal anastomotic stenosis were cured by operation. All patients were followed up for 1 to 25 years with satisfactory results. Renal function and morphology were significantly improved compared with those before surgery. Three cases had vesicoureteral reflux at 1 year after operation, all of which were below L5 transverse process, and 1 case had 3 years after operation Died of viral encephalitis. That the ileal ureter is a better type of kidney surgery, suitable for long ureteral lesions, giant ureter, severe hydronephrosis, angioplasty failure and associated with recurrent stones, etc .; as long as the correct treatment of urinary tract infection , Electrolyte imbalance and vesicoureteral reflux and other complications, can achieve satisfactory results.