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原发性梗阻性巨输尿管

Primary obstructed megaureter

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【作者】 蒋先镇黄福溥申鹏飞

【Author】 Jiang Xian-zhen; Huang Fu-pu; Shen Peng-fei(Department of Uorlogy, Xiangya Hospital, Hunan Medical University, Chang-sha 410008)

【机构】 湖南医科大学附属湘雅医院泌尿外科

【摘要】 1982~1991年间收治原发性梗阻性巨输尿管23例。儿童17例,成人6例。按1976年美国费城小儿泌尿会议分类原则,本组病例包括输尿管末端闭锁、输尿管异位开口和无动力性输尿管。外科治疗24侧巨输尿管,其中肾、输尿管切除5侧,输尿管再植19侧。9侧输尿管末端切除后病检发现炎性反应,纤维及胶原组织增多,肌纤维减少,未见到副交感神经细胞。随访18例输尿管再植患者,4例失访,14例良好,其中10例复查IVU和VCUG,9例输尿管显著缩小,肾功能改善,1例无变化,无膀胱输尿管返流。结合文献复习,对分类、病理,诊断和治疗进行了讨论。

【Abstract】 Twenty-three cases of primary obstructive megaureters has been admitled during l982~1991, with 6 in adult and 17 in children. This series consisted of atresia of ureteral end segment,ectopic ureter and adynamic ureter. 24 ureters were treated surgically, total renoureterectomy on the involved side being carried out for 5.Ureteral reimplantation with Politano-Leadbetter’s technique was adopted for 19 ureters. The obstructive segment was resected in 9 cases, and histopathological examination of the distal ureter showed inflammation and increase collagen tissue with reduction of musculature. Parasympatholytic cell has never been observed.Of the 18 patients with reimplantation, 14 have had a good condition while the other 4 were missed. IVU and UCUG in 10 patients after operation showed that renal fanction has been improved with a marked reduction of ureteral diameter in 9 and vesicoureteric reflux has not been observed.The classification, pathology, clinical symptoms, morphologic features, diagonosis and surgical treatment were discustsed.

【关键词】 输尿管畸形再植
【Key words】 UreterAbnormalities Replantation
  • 【文献出处】 中华泌尿外科杂志 ,CHINESE JOURNAL OF VROLOGY , 编辑部邮箱 ,1994年02期
  • 【分类号】R693.13
  • 【被引频次】7
  • 【下载频次】54
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