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-  2015 

106例儿童完全型重复肾输尿管畸形的诊治经验

DOI: doi:10.7507/1002-1892.20150302

Keywords: 重复肾输尿管畸形, 输尿管残端综合征, 肾积水, 输尿管异位开口, 输尿管囊肿, 输尿管狭窄, 儿童

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Abstract:

目的探讨儿童完全型重复肾输尿管畸形的临床分类标准及治疗方案。 方法回顾分析2000年3月-2015年2月收治的106例完全型重复肾输尿管畸形患儿临床资料。其中男11例,女95例;年龄1个月~11岁,平均3.5岁。单侧88例,双侧18例。根据患儿影像学检查结果和临床表现,按照自定分类标准分为4类:第1类14例,未作特殊处理;第2类15例,行重建吻合术;第3类74例,手术切除发育不良肾段以及引流该肾段的输尿管;第4类3例,选择患侧全肾切除以及患侧输尿管大部分切除治疗。 结果106例患儿均获随访,随访时间2个月~14年,中位时间23个月。第1类患儿病情无进展。第2、3、4类患儿术后均无漏尿、腰肋部不适、排尿时阴部包块突出、生殖道感染、血尿等并发症发生;血常规、肾功能及电解质未见异常。7例出现输尿管残端综合征,其中第2类1例、第3类6例;4例出现尿路感染,其中第2类1例、第3类3例;3例术后残留轻度肾段积水,均为第2类。 结论根据完全型重复肾输尿管畸形的临床分类,选择个体化治疗方案,能最大程度保留有效肾单位,提高患儿生活质量,获得较好疗效

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