摘要
目的总结高压球囊扩张联合输尿管支架置入术治疗婴幼儿先天性梗阻性巨输尿管的临床经验及疗效,探讨该方法对于婴幼儿先天性梗阻性巨输尿管的治疗价值。方法回顾性收集2015年1月到2020年12月北京和睦家医院外科收治的19例先天性梗阻性巨输尿管患儿临床资料,收集并分析19例患儿的治疗经过及预后情况。结果19例均行高压球囊扩张联合输尿管支架置入术治疗,其中12例经1次高压球囊扩张联合输尿管支架置入术治愈;5例经2次高压球囊扩张联合输尿管支架置入术治愈。2例治疗失败,其中1例失败原因为输尿管膀胱入口处严重狭窄、无法置入导丝;另1例经2次高压球囊扩张联合输尿管支架置入术治疗后症状无改善,最终经输尿管膀胱再植术治愈。17例获治愈患儿均于术后6个月复查放射性核素显像及肾盂输尿管B超,患儿分肾功能均有不同程度改善;随访7~26个月(平均随访14个月),无一例复发。结论高压球囊扩张联合输尿管支架置入术治疗婴幼儿先天性梗阻性巨输尿管安全、有效、可行。
Objective To assess the efficacy of high-pressure balloon dilation of ureterovesical junction for primary obstructive megaureter in children.Methods A total of 19 children with primary obstructive megaureter underwent high-pressure balloon dilation under general anesthesia from January 2015 to December 2020.Results Significant postoperative improvement of hydroureteronephrosis were noted in 12 cases after single treatment,5 children achieved cure after a second treatment and another 2 underwent ureteral bladder reimplantation after a failure of dilation.Insertion of guide wire failed in one case while another child showed no improvement after a second dilation.At 6 months post-operation,radionuclide imaging indicated improvements of renal function and hydroureteronephrosis in 17 children after dilation.During an average follow-up period of 14(7-26)months,there was no sign of recurrence.Conclusion High-pressure balloon dilation of ureterovesical junction is both safe and effective for primary obstructive megaureter in children.
作者
郭玉峰
张钦明
张璟
陈迪祥
Guo Yufeng;Zhang Qinming;Zhang Jing;Chen Dixiang(Department of Pediatric Surgery,Beijing United Family Hospital,Beijing 100015,China)
出处
《临床小儿外科杂志》
CAS
CSCD
2022年第6期562-566,共5页
Journal of Clinical Pediatric Surgery
