输尿管膨出症的临床特征及内镜治疗

摘要

目的 探讨输尿管膨出症的临床特点,总结其诊断、治疗及术后随访的要点.方法 选择2008年3月～2011年12月南京大学医学院附属鼓楼医院收治的输尿管膨出症24例临床资料.术后3、6个月及术后1、2年随访,观察术后患者尿路感染、肾积水的变化情况及有无膀胱输尿管反流现象的发生.结果 24例患者手术一次成功19例,术后定期尿常规、B超、静脉肾盂造影、膀胱造影等复查,3例合并重复肾、输尿管畸形的输尿管膨出患者存在术后膀胱输尿管反流,予保守治疗,定期随访.结论 经尿道内镜手术是治疗输尿管膨出安全、有效地方法,其存在术后发生膀胱输尿管反流的固有风险,但只要不引起反复尿路感染,大多病例可随诊观察.%Objective To explore the clinical features of ureterocele and to summarize the key points of the diagnosis, treatment and follow-up.Methods Clinical data of 24 cases of ureterocele treated by transurethral incision from March 2008 to December 2011 in Drum Tower Hospital Affiliated to Medical College of Nanjing University were analyzed retrospectively.Results 19 cases were found obtained successful results by primary endoscopic incision of all the 24 cases.Follow-up was ranged with urine routine, regular B-ultrasonography, intravenous urography and cystography.3 cases who have abnormalities duplex kidney and ureter were found to have vesicoureteric reflux (VUR) after operation and managed conservatively.Conclusion Endoscopic incision of ureterocele is a safe and effective treatment of urete-roceles.There is an inherent risk of producing VUR in the postincision period, however, it is right to manage conservatively without causing recurrent urinary tract infections.