小儿输尿管发育异常的诊治探讨

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1、小儿输尿管发育异常的诊治探讨【关键词】生长和发育【摘要】目的探讨小儿输尿管发育异常的诊断及治疗。方法近4年收治输尿管发育异常16例，采用发育不良肾脏及输尿管的切除，巨型输尿管的裁剪整形、输尿管再植等治疗。术前经静脉尿路造影（IVU）、B超、CT、MRI等检查，结合病史、手术所见、病理发现对其诊断及治疗进行评价。结果本组16例，13例女性。结构异常11例、末端异常10例、数目异常7例。B超发现8例发育不良的肾脏。单输尿管发育不良并肾发育不良者，IVU仅能部分发现，合并重复肾者7例，其中5例静脉肾盂

2、造影IVP）均全程显影。7例（10条）巨输尿管2例并肾发育不良，IVP未显影。发育异常输尿管合并发育不良肾或巨输尿管合并发育不良肾及重复肾功能不良者原则上应行发育不良输尿管及肾的切除，若重复肾输尿管功能好可考虑保留，有开口异位者则需输尿管再植入膀胱。原发巨输尿管可行裁剪整形，并肾功能差者行巨输尿管及发育不良肾的切除。结论输尿管发育不良在女性多见;结构异常最多见、末端异常次之。诊断应注重病史中会阴部漏尿，反复泌尿系感染，结合B超多能发现，IVP检查作为必要补充以鉴别并利定侧。应依患儿的具体病情对应处理。关键词肾生长和发育输

3、尿管畸形超声检查诊断和治疗Children’sureteralheteroplasia:diagnosisandmanagementChenZhongxian，JiangXuewu，WangGuanghuan，etal.DepartmentofPediatricSurgery，TheSeco

4、ndAffliatedHospital，MedicalCollegeofShantouUniversity，Shantou，Guangdong515041.【Abstract】ObjectiveTostudythediagnosisandtreatmentofureterdisplasiainwean.MethodsSince1999，16childrenagingfrom3to10yearsofureterdisplasiawereadmitted.AllcaseshadIVU，ultrasound（US）.someo

5、fthemhadCT，MRIexamination.13caseswerereceivedureteronephrectomy，giganticureteralplastyorureterreˉplantedetc.Theeffectsofthediagnosisandtreatmentofureterdisplasiawereevaluatedthroughoperationandpathoˉlogicalexaminationanddiseasehistory.ResultsInthe16cases，13werefe

6、male.amongthem，11caseswerestructureabnormalty，10caseswereendabnormality，7caseswerenumberabnormality.Displasiakidneyswerefoundin8casesbyUS.RenaldisplasiawithsingleuretercanbefoundbyIVUinalittleamountcases.Kidneyandureterwerefoundcompletelyin5casesbyIVUin7casesofur

7、eterdisplasiawithrepeatingkidney.DisplasiakidneyandureterwerenotfoundbyIVUinthe2caseswithrenaldisplasiain7casesofgiganticureter.ConclusionUreteraldisplasiaisfreˉquentlyinfemale.Themostisstructureabnormality，thesecondisendabnormality.Thehistorywithleakingurineinth

8、eperineumorrepeatfulurinarysysteminfectionshouLdbepayattention.MostcasesmaybefoundbytypicallhistoryandUSexamination.IVUisanecessarysupplymentarymethodtohelpfin