| 摘要: |
| ［摘要］ 目的 探讨重复肾输尿管畸形诊断治疗方法，提高诊治水平。方法 回顾性分析1998-03～2008-08收治的23例重复肾输尿管畸形的临床病例资料，其中男性4例，女性19例，年龄9～36岁，症状分别为：腰腹部胀痛或包块10例，漏尿5例，反复发热4例，膀胱刺激征4例。辅助检查：超声23例，静脉肾盂造影(IVU)23例，膀胱镜检查逆行肾盂造影(RPG)13例，CT检查16例，磁共振泌尿系水成像(MRU)4例。明确诊断重复肾输尿管畸形，23例均行个体化手术治疗。结果 23例全部经手术治疗康复出院，17例获随访6个月～5年，其中1例出现后腹腔尿性囊肿，经再次手术切除剩肾而治愈，2例仍出现轻度肾积水，予观察肾积水未加重而未处理。结论 对于重复肾输尿管畸形的诊断，临床表现结合超声、IVU检查对部分病例可明确诊断，而对肾积水严重、肾功能低下IVU显影淡薄或不显影，仅显示正常肾管道系统，易造成误诊或漏诊；RPG可明确重复肾输尿管积水原因和部位，但为有创检查；CT检查快速、简便,可显示重复肾输尿管畸形部位，为手术方案和切口选择提供依据；MRU诊断重复肾输尿管异位开口具有较高准确性和敏感性，能对其作出较好诊断。治疗上应视畸形的病变部位及并发症严重程度采取个体化的手术治疗。 |
| 关键词: 重复肾输尿管畸形 诊断 外科手术 泌尿系 |
| DOI：10.3969/j.issn.1674-3806.2010.04.13 |
| 分类号:R 691.1 |
| 基金项目: |
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| Diagnosis and treatment of 23 cases of duplex kidney and ureter with clinical symptoms |
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ZHANG Xiong-wei, CHEN Qiang-wen, ZHOU Lian-xing, et al.
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Department of Urology, People′s Hospital of Hezhou, Guangxi 542800, China
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| Abstract: |
| ［Abstract］ Objective To evaluate the diagnostic methods of duplex kidney and ureter in order to improve diagonosis of this disease.Methods The clinical data of 23 patients with duplex kidney and ureter hospitalized in our hospita1 from March 1998 to August 2008 were retrospectively analyzed,of them 4 cases are male,19 cases were female;the age ranged from 9 to 36，the symptoms included lumbar/abdominal pain or masses in 10 patients,leakage of urine 5 patients, irritative symptoms of bladder 4 patients.Accessory examination included ultrasonic diagnosis in 23 patients,IVU 23 patients, RPG 13 patients, CT 16 patients, MRU 4 patients，all 23 patients were diagnosed as duplex kidney and ureter， all 23 patients were treated by surgery.Results After operation all 23 cases were recovery，of them 17 cases were followed up for 6 months to 5 years，of them 1 case were found retroperitoneal urinary cyst,after operation this case were recovery; 2 cases were found mild uronephrosis and the sympotm was stable.Conclusion The diagnosis of duplex kidney and ureter could be confirmed on the basis of clinical manifestation, ultrasonic diagnosis and IVU in some patients, but in the patient with severe uronephrosis and low renal function the poor result of IVU could lead to wrong diagnosis.RPG could find the reason and location of uronephrosis but it is an invasive examination.CT is a simple and fast examination,it could demonstrate the location of duplex kidney and ureter so it could provide useful information for operation.MRU examination has high accuracy and sensibility for the location of abnormal opening.The operation should be taken according to the location and complication of different patients. |
| Key words: Duplex kidney and ureter Diagnosis Surgery Urinary system |
