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[肾积水的原理及手术方法的选择]

[Principle of hydronephrosis and choice of surgical method].

作者信息

Karpenko V S

出版信息

Urologiia. 2002 May-Jun(3):43-6.

Abstract

Experience in operative treatment of 1574 patients suffering from hydronephrosis is analysed. Among them, 656 patients were operated in the Chernobyl zone. Radical surgery, palliative operations and nephrectomy were performed in 63, 21.5 and 16.5% patients, respectively. According to operative electropyeloureterography and histological examination of the removed material, circulatory segmental hypoplasia of near pelvis ureter in hydronephrosis had decreased electric potentials, up to their absence, urodynamic disorders. Ureteral hypoplasia is often associated with high branching of the ureter, additional aberrant renal vessel. In functional hydronephrosis it may be a primary cause of hydronephrosis and influence the choice of the operative treatment. Postoperative course of hydronephrosis in the Chernobyl zone is characterized by more frequent complications because of subnormal immunity and high virulence of urinary infection. For 12 years after the Chernobyl accident, no direct effects of low-dose radiation on renal function is ascertained. Renal function after radical plastic operations depended on the disease severity. In the Chernobyl zone all kinds of radical plastic operations in hydronephrosis were performed.

摘要

分析了1574例肾积水患者的手术治疗经验。其中,656例患者在切尔诺贝利地区接受了手术。根治性手术、姑息性手术和肾切除术分别在63%、21.5%和16.5%的患者中进行。根据手术性肾盂输尿管造影和切除组织的组织学检查,肾积水患者近肾盂输尿管的循环节段发育不全具有电位降低,直至电位消失,存在尿动力学障碍。输尿管发育不全常与输尿管高度分支、额外的肾迷走血管有关。在功能性肾积水中,它可能是肾积水的主要原因,并影响手术治疗的选择。切尔诺贝利地区肾积水的术后病程以并发症更为频繁为特征,这是由于免疫力低下和泌尿系统感染的高毒力所致。切尔诺贝利事故发生12年后,未确定低剂量辐射对肾功能有直接影响。根治性整形手术后的肾功能取决于疾病的严重程度。在切尔诺贝利地区,对肾积水进行了各种根治性整形手术。

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