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目的探讨先天性巨输尿管症诊断及治疗方法。方法回顾性分析35例先天性巨输尿管症患儿的临床资料。结果本组中单侧先天性巨输尿管症29例,双侧6例;15例行膀胱输尿管吻合术,20例行输尿管末端折叠后输尿管膀胱吻合术;术后随访1～5a,1例有尿频症状,轻度尿路感染2例,其余患儿临床症状消失,超声检查示输尿管无扩张,肾盂积水有不同程度减轻或消失。结论对先天性巨输尿管症合并尿液引流功能严重损害者,或观察期间肾功能恶化、有反复发作泌尿系感染、肾盂与输尿管扩张进行性加重者应及时手术治疗;对临床症状轻、输尿管和肾盂轻中度扩张、无明显泌尿系感染及肾功能正常者,应严密临床观察,待1岁以后再行手术治疗。
Objective To investigate the diagnosis and treatment of congenital giant ureter. Methods The clinical data of 35 cases of congenital giant ureteral diseases were retrospectively analyzed. Results In this group, 29 cases of unilateral ureteral giant ureter, bilateral in 6 cases; 15 cases of ureterovascular anastomosis, 20 cases of ureter endoscopic ureteral anastomosis; 1 to 5 years follow-up, 1 case of urinary frequency Symptoms, mild urinary tract infection in 2 cases, the remaining children with clinical symptoms disappeared, ultrasound showed no expansion of the ureter, hydronephrosis have reduced or disappeared in varying degrees. Conclusions Patients with congenital giant ureter complicated by severe drainage of urine, or worsening of renal function during the observation, recurrent urinary tract infection, renal pelvis and ureteral dilatation should be timely surgical treatment; clinical symptoms of light, ureteral and Moderate renal pelvis dilatation, no obvious urinary tract infection and renal function were normal, should be closely observed, to be re-operated after 1 year of age.