【摘要】 目的 :探讨下腔静脉后输尿管的诊治方法。方法 :18例患者男 15例 ,女 3例 ,年龄 18～ 6 1(平均 36 )岁 ,其中腔静脉后输尿管合并隐睾和尿道下裂各 1例。全部行静脉尿路造影 (IVU)、B超检查和逆行尿路造影 (RU) ,5例行CT检查 ,7例磁共振尿路造影 (MRU)。特征性影像学表现为输尿管呈反J形或横S形。治疗采用输尿管切断复位矫正术 ,术中切除下腔静脉后有病变的输尿管 2～ 3cm ,无张力吻合输尿管。结果 :术后 3～ 6月复查症状消失 ,肾积水均有不同程度减轻 ,吻合口无狭窄。结论 :IVU和RU是诊断下腔静脉后输尿管的良好方法 ,输尿管切断矫正复位术是治疗此病的首选方式。更多还原

【Abstract】 Objective:To study the diagnosis and treatment of retrocaval ureter.Methods:Eighteen cases of retrocaval ureter with an averae age of 36 years (range from 18 to 61 years old)were reported. Two cases of retrocaval ureter had a glandular hypospadias and cryptorchidism respectively.The diagnosis depends on intravenous urography(IVU), retrograde ureterography(RU), magnetic resonance ureterography (MRU) , B-ultrasound and CT. Operation was the principal treatment. Ureter orthopedics and reduction were performed in all cases of type 1 (low loop). After removing 2 to 3 cm retrocaval ureter with pathological changes, the ureter was anastomosed without tention and regained its normal anatomic position. Results:All 18 cases were correctly diagnosed preoperatively.IVU and RU or MRU showed right hydronephrosis with reversed ‘J shaped’ , taper and horizontal ‘S shaped’ ureter. B-ultrasound and excretory urography showed no stenosis and improvement of hydronephrosis. Conclusion:IVU and RU are better methods to diagnose retrocaval ureter.Ureter orthopedics and reduction are ideal for the treatment of retrocaval ureter.更多还原