ISSN 1674-3865  CN 21-1569/R
主管：国家卫生健康委员会
主办：中国医师协会
　　　辽宁省基础医学研究所
　　　辽宁中医药大学附属医院
中国中西医结合儿科学

中国中西医结合儿科学 ›› 2017, Vol. 9 ›› Issue (5): 404-407.doi: 10.3969/j.issn.1674-3865.2017.05.012

• 临床研究 • 上一篇    下一篇

肾盂输尿管交界处狭窄致肾积水患儿术后肾形态及功能恢复研究

彭潜龙，赵夭望，刘小青，殷波   

  1. 410007 长沙，湖南省儿童医院泌尿二科
  • 出版日期:2017-10-25 发布日期:2017-12-18
  • 通讯作者: 彭潜龙，E-mail:xiangyawhy@126.com

Study on postoperative recovery of renal morphology and function in children with hydronephrosis caused by stenosis of ureteropelvic junction

PENG Qianlong，ZHAO Yaowang，LIU Xiaoqing，YIN Bo   

  1. Hunan Children 's Hospital，Changsha 410007，China
  • Online:2017-10-25 Published:2017-12-18

PDF (PC)

118

摘要：
目的
观察肾积水患儿术后肾形态及功能恢复的情况。
方法
选择2013年1月30日至2016年6月30日湖南省儿童医院泌尿二科收治的肾盂输尿管交界处狭窄致肾积水并行手术治疗的患儿85例作为研究对象，观察术后临床疗效及B超检测肾盂长径和前后径、肾体积、肾皮质厚度，检测血肌酐和尿素氮水平。
结果
患儿患侧肾皮质厚度术后2周明显增加，术后24周趋于稳定，肾皮质厚度显著高于术前，差异有统计学意义（P<0.05）|患侧肾体积术后2周明显缩小，术后8周趋于稳定，术后32周患侧肾体积与术前比较，差异有统计学意义（P<0.05）|肾盂长径术后4周明显缩短，术后8周趋于稳定，与术前比较差异有统计学意义（P<0.05）|肾盂前后径术后逐渐缩短，术后32周趋于稳定，与术前比较差异有统计学意义（P<0.05）。肾积水患儿术后血肌酐和尿素氮水平均低于术前，差异有统计学意义（P<0.05）。85例患儿肾积水术后肾功能恢复总有效率为96.47%（82/85)，恢复良好。
结论
肾积水患儿术后肾体积无变化，患肾皮质厚度、肾盂长径、肾盂前后径形态明显改善，且随着恢复时间的增加趋于稳定，术后6～8个月各项指标趋于稳定。术后患肾功能及形态恢复良好，手术效果显著。

关键词: 肾积水, 术后, 肾形态, 肾功能恢复, 儿童

Abstract:
Objective
To observe the postoperative recovery of renal morphology and function in children with hydronephrosis.
Methods
A total of 85 children were included in the study, who received operation for hydronephrosis caused by stenosis of ureteropelvic junction in Hunan Children's Hospital from Jan. 30, 2013 to June 30, 2016. Observe the clinical effect after operation and determine the long diameter and the anterior and the posterior diameter of pelvis, renal volume and the thickness of renal cortex by B-ultrasound, and the level of serum creatine and urea nitrogen was detected.
Results
At two weeks after surgery, the thickness of renal cortex at the affected side was significantly increased and became stable at 24 weeks after surgery, and the thickness was significantly higher than that before surgery, the difference being statistical(P<0.05);the renal volume was significantly reduced and became stable at 8 weeks after operation, and comparing the volume at 32 weeks with that before surgery, there was statistically significant difference (P<0.05).At 4 weeks after surgery, the pelvic long diameter was significantly shortened and became stable at 8 weeks,there being statistical difference compared with before operation(P<0.05).After operation, the pelvic anterior and posterior diameter was gradually reduced and became stable at 32 weeks after operation, and there was statistical difference compared with before operation(P<0.05).The level of serum creatine and urea nitrogen after surgery was lower than that before, and the difference was statistical(P<0.05).The total effective rate of renal function recovery in the 85 children with hydronephrosis was 96.47%（82/85) after operation, which proved to be a good recovery.
Conclusion
There is no change in the postoperative renal volume in children with hydronephrosis; the thickness of the renal cortex, pelvic long diameter, and the morphology of anterior and posterior diameter are obviously improved and become stable with the time passing, which reach the stable state at 6 to 8 months after operation. The renal function and morphology recover well and the clinical effect of operation is excellent.

Key words: Hydronephrosis, Postoperative, Renal morphology, Renal function recovery, Children