| 曹永胜,彭博,刘项,等.经腹腹腔镜肾盂成形术治疗小儿肾盂输尿管连接处梗阻32例临床分析[J].安徽医药,2017,21(7):1237-1240. |
| 经腹腹腔镜肾盂成形术治疗小儿肾盂输尿管连接处梗阻32例临床分析 |
| Transperitoneal laparoscopic pyeloplasty in treating ureteropelvic junction obstruction:a clinical analysis of 32 children cases |
| 投稿时间：2017-02-19 |
| DOI： |
| 中文关键词: 腹腔镜 肾盂成形术 肾盂输尿管连接处梗阻 儿童 |
| 英文关键词: Laparoscopy Pyeloplasty Ureteropelvic junction obstruction Children |
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| 中文摘要: |
| 目的 探讨经腹腔入路腹腔镜肾盂输尿管成形术治疗小儿肾盂输尿管连接处梗阻(UPJO)的临床价值。方法 对行经腹腔入路腹腔镜肾盂输尿管成形术治疗的32例小儿肾盂输尿管连接处梗阻的临床资料加以总结,男26例,女6例,左侧25例,右侧7例,年龄6月13 d~10岁,中位年龄3岁。观察其手术时间、术中出血量、术后疼痛程度、术后腹腔引流量、切口外观、术后住院时间。术后随访6~24个月,复查B超、静脉尿路造影(IVU)、尿常规,观察肾盂分离程度、肾实质厚度变化及输尿管通畅程度、有无尿路感染。 结果 32例均顺利完成手术,无中转开放手术。手术时间140~330 min,平均216 min。术中出血2~10 mL,平均4.7 mL。术后均无明显疼痛。术后3 d腹腔日均尿引流量0~220 mL,平均35 mL。腹腔引流管放置时间4~16 d,平均6 d。术后肠道恢复时间1~3 d,平均1.9 d。术后住院日4~19 d,平均10 d。术后随访B超示肾盂分离程度均逐渐减轻、肾实质厚度逐渐增加,IVU示输尿管均通畅、肾积水好转,无尿路感染。切口瘢痕轻微。 结论 经腹腔入路腹腔镜肾盂输尿管成形术治疗小儿肾盂输尿管连接处梗阻,疗效满意、损伤少、痛苦小、瘢痕轻微、美容效果好,值得推广。 |
| 英文摘要: |
| Objective To evaluate the clinical value of transperitoneal laparoscopic pyeloplasty in the treatment of pediatric ureteropelvic junction obstruction (UPJO).Methods The clinical data were summarized of 32 cases of pediatric UPJO treated by transperitoneal laparoscopic pyeloplasty.There were twenty-six boys and six girls.Twenty-five patients had left unilateral UPJO and seven had right unilateral UPJO.Patients undergoing surgery aged between 6 months and 13 days and 10 years old (median 3 years).Observation was performed in the operative time,intraoperative blood loss,postoperative pain,postoperative abdominal drainage volume,incision appearance and postoperative hospital stay.And after 6 to 24 months,we reviewed the patients with ultrasonography,IVU,and urinalysis,observed the degree of renal pelvis separation,changes in renal parenchyma and ureter patency,and urinary tract infection.Results All patients were successfully completed by transperitoneal laparoscopic pyeloplasty.No patient was required conversion to open surgery.Median operative time was 216 minutes (range 140-330 min).No obvious pain was reported after surgery.Median intraoperative blood loss was 4.7 mL (range 2-10 mL).The average daily urine drainage volume was 35 mL (range 0-220 mL) during the first 3 days.The average drainage time was 6 days (range 4-16 d).Median intestinal recovery time was 1.9 days (range 1-3 d).The average postoperative hospital stays were 10 days (range 4-19 d).The postoperative ultrasonography showed that the degree of pyelic separation was gradually reduced,the thickness of renal parenchyma was gradually increased.IVU showed unobstructed ureters,improved uronephrosis and no recurrence of urinary tract infection.Incision scars were getting slighter.Conclusions Transperitoneal laparoscopic pyeloplasty is an effective option for the surgical treatment of children with UPJO,which creates a satisfied curative effect with less injury,less pain,slighter scar,and better cosmetic effect.So this method is worthy of promotion. |
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