腹腔镜离断式肾盂输尿管成形术治疗UPJO肾积水患儿围术期指标术后并发症及预后的影响

doi:10.3969/j.issn.1006-6233.2020.10.019

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摘要 目的: 研究腹腔镜离断式肾盂输尿管成形术(LDP)治疗肾盂输尿管连接部梗阻(UPJO)肾积水患儿围术期指标、术后并发症及预后的影响。方法: 便利抽样法选择本院2016年9月至2019年9月诊治的190例UPJO肾积水患儿进行回顾性分析,按照手术分为研究组(106例)和对照组(84例),前者给予LDP术,后者给予开放肾盂成形术。观察并比较两组围术期指标、术后并发症,并评估术后患儿肾形态和肾功能情况。结果: 研究组患儿手术时间多于对照组,术中出血量、住院时间以及镇痛剂用量均低于对照组(P<0.05);术后并发症发生率显著低于对照组(5.66% vs 14.19%,P<0.05);与术前相比,两组患儿术后半年肾实质厚度、肾小球滤过率(GFR)均升高,肾体积、血肌酐(Scr)水平均降低,且术后3个月研究组升高或降低幅度高于对照组(P<0.05),但术后半年两组比较无显著差异(P>0.05)。结论: LDP术治疗UPJO肾积水患儿安全有效,可减少术中出血以及术后并发症,促进术后肾脏形态、肾功能恢复,改善预后。

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	周恩惠

关键词 ：腹腔镜, 离断式肾盂输尿管成形术, 肾盂输尿管连接部梗阻, 肾积水, 术后并发症

Abstract：Objective: To study the effect of laparoscopic dismembered pyeloplasty (LDP) on perioperative indexes, postoperative complications and prognosis in children with hydronephrosis caused by ureteropelvic junction obstruction (UPJO). Methods: A retrospective analysis was conducted. 190 children with hydronephrosis caused by UPJO diagnosed and treated in the hospital between September 2016 and September 2019 were selected by convenience sampling. They were divided into the study group (106 cases) and the control group (84 cases) according to the operation methods. The former were treated with LDP and the latter were treated with open pyeloplasty. Observe and compare the perioperative indicators and postoperative complications of the two groups, and evaluate the renal morphology and renal function of the children after surgery. Results: The operation time of the study group was longer than that of the control group. The intraoperative blood loss, length of hospital stay and the dosage of analgesics were less or shorter than those of the control group (P<0.05). The incidence of postoperative complications was significantly lower than that of the control group (5.66% vs 14.19%, P<0.05). The thickness of renal parenchyma and glomerular filtration rates (GFR) in the two groups were increased, while the renal volume and serum creatinine (Scr) levels were decreased in 6 months after operation. Besides, the increase or decrease in study group was greater than that in the control group at 3 months after operation (P<0.05). However, there was no significant difference between the two groups at 6 months after operation (P>0.05). Conclusion: LDP is safe and effective in the treatment of children with hydronephrosis caused by UPJO. It can reduce the intraoperative blood loss and postoperative complications, promote postoperative recovery of renal morphology and renal function, and improve the prognosis.

Key words： Laparoscope Dismembered pyeloplasty Ureteropelvic junction obstruction Hydronephrosis Postoperative complications

基金资助:江苏省卫生科研项目,(编号:H20170491)

引用本文:

周恩惠. 腹腔镜离断式肾盂输尿管成形术治疗UPJO肾积水患儿围术期指标术后并发症及预后的影响[J]. 河北医学, 2020, 26(10): 1663-1667.
ZHOU Enhui. Effect of Laparoscopic Dismembered Pyeloplasty on Perioperative Indexes Postoperative Complications and Prognosis in Children with Hydronephrosis Caused by UPJO. HeBei Med, 2020, 26(10): 1663-1667.

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http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2020.10.019 或 http://www.hbyxzzs.cn/CN/Y2020/V26/I10/1663

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