摘要
先天性肾积水(congenital hydronephrosis,CHn)是儿童泌尿生殖系统常见的疾病,新生儿肾积水的发生率为1%~2%。CHn病因复杂,最常见原因是肾盂输尿管连接部梗阻(ureteropelvic junction obstruction,UPJO),占85%以上。临床上UPJO所致肾积水通常选择肾盂输尿管成形术,分肾功能(differential renal function,DRF)是目前指导手术时机较可靠的指标,但DRF<10%肾积水的治疗方案尚存争议。本文通过对DRF<10%肾积水的治疗方法及影响因素进行综述,比较不同治疗方案的优缺点及预后,探讨影响患肾功能恢复的潜在因素,旨在提高DRF<10%肾积水的治疗效果。
Congenital hydronephrosis(CHn)is a common disease of genitourinary system in children.The incidence of neonatal hydronephrosis is around 1%-2%.The etiology of CHn is rather complex.One of the most common causes is ureteropelvic junction obstruction(UPJO),accounting for over 85%.Clinically pyeloplasty is indicated for mild,moderate and severe hydronephrosis caused by UPJO while an optimal treatment of extremely severe hydronephrosis is still under debate.Pyeloplasty is ideal for hydronephrosis due to UPJO.Currently split renal function(SRF)is a more reliable indicator for guiding operative timing.However,treatment planning for hydronephrosis with SRF<10%has remained controversial.This review summarized treatment options and influencing factors of hydronephrosis with SRF<10%,compared the advantages,disadvantages and prognoses of different treatment,explored the potential factors of affecting the recovery of renal function and intended to improve the therapeutic outcomes of hydronephrosis with SRF<10%.
作者
李小瑜(综述)
郭云飞
黄立渠(审校)
Li Xiaoyu;Guo Yunfei;Huang Liqu(Department of Urology,Affiliated Children's Hospital,Nanjing Medical University,Nanjing 210008,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2021年第12期1183-1188,共6页
Journal of Clinical Pediatric Surgery
基金
江苏省自然科学基金(编号:BK20200152)。
关键词
肾盂积水
输尿管处梗阻
肾切除术
肾造口术
经皮
预后
影响因素分析
Hydronephrosis
Ureteral Obstruction
Nephrectomy
Nephrostomy,Percutaneous
Prognosis
Root Cause Analysis