河北医科大学学报

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置入输尿管支架管早期干预小婴儿重度肾积水的疗效评估

  

  1. 河北医科大学附属河北省儿童医院泌尿外科,河北 石家庄 050031
  • 出版日期:2020-03-25 发布日期:2020-04-02
  • 作者简介:张铁军(1975-),男,河北邯郸人,河北医科大学附属河北省儿童医院副主任医师,医学学士,从事小儿泌外科疾病诊治研究。
  • 基金资助:
    河北省医学科学研究重点课题(20150555)

Efficacy evaluation of early placement double J ureteral catheter on severe hydronephrosis in infants

  1. Department of Urology, Affiliated Hebei Children′s Hospital of Hebei Medical University, Shijiazhuang  050031, China
  • Online:2020-03-25 Published:2020-04-02

摘要: [摘要]
目的  观察输尿管支架管(double J ureteral catheter,简称“DJ”管)置入术后小婴儿重度肾积水相较术前指标变化,探讨此手术方案在临床上的应用价值。
方法  回顾性分析小于3个月重度肾积水患儿20例,患儿均于膀胱镜下逆行留置输尿管DJ管,分析置入术后对肾积水的治疗效果。
结果  20例患儿中,2例未能成功置入输尿管DJ管改行肾造瘘术,2例术后发生输尿管DJ管梗阻给予置换输尿管DJ管后恢复良好,10例于6个月后拔除输尿管DJ管肾积水再次加重明显给予肾盂输尿管离断成形,8例拔除输尿管DJ管后肾积水明显缓解无再次加重表现观察至今无特殊处理。输尿管DJ管置入患儿治疗前、治疗后2周及治疗后6个月比较,内引流效果良好,肾积水程度明显缓解(P<0.01)。
结论  输尿管DJ管置入术操作简单,手术时间短,可明显缓解小婴儿重度肾积水程度,术后患儿恢复快,皮肤无破损及外置引流管,护理方便,6个月后拔除输尿管DJ管后患儿有一定概率免于较大手术创伤可能,故值得在临床上进一步应用研究。

关键词: 重度肾积水, 输尿管支架管, 婴儿

Abstract: [Abstract] ObjectiveTo observe the index changes after placement the double J ureteral catheter(DJ) in small infants with severe hydronephrosis and to discuss the clinical application value of this surgical plan.
〖WTHZ〗MethodsTwenty children with severe hydronephrosis less than 3 months were analyzed retrospectively. All the patients were placed ureteral DJ tube retrogradely under cystoscope to analyze the therapeutic effect of hydronephrosis after operation.
〖WTHZ〗ResultsOf 20 children, 2 failed to put the ureteral DJ tube into the nephrostomy, and 2 had ureteral DJ tube obstruction. The ureteral DJ tube recovered well after replacement. The hydronephrosis was aggravated again in 10 cases after 6 months, and the pyeloureteroplasty was performed. 8 cases of hydronephrosis were relieved after removal of ureteral DJ tube, and there was no further aggravation. The effect of internal drainage was good before treatment, 2 weeks after treatment and 6 months after treatment. The degree of hydronephrosis in children after indwelling ureteral DJ tube was obviously relieved(P<0.01).
〖WTHZ〗ConclusionThe DJ placement procedure is simple and the operation time is short, which can significantly alleviate the degree of severe hydronephrosis in small infants. After the operation, the children recovers quickly and convenient for nursing. After the removal of the ureteral DJ tube 6 months later, the children have a certain probability of avoiding major surgical trauma, which is worthy of further clinical application.

Key words: severe hydronephrosis, double J ureteral catheter, infant