Madden N P, Thomas D F, Gordon A C, Arthur R J, Irving H C, Smith S E
Department of Paediatric Surgery, St James's University Hospital, Leeds.
Br J Urol. 1991 Sep;68(3):305-10. doi: 10.1111/j.1464-410x.1991.tb15329.x.
We report follow-up data (minimum of 1 year) on 63 kidneys with antenatally detected pelviureteric junction obstruction, as defined by renographic criteria. The condition was bilateral in 10 patients (i.e. 20 kidneys), 2 patients had unilateral obstruction with contralateral multicystic dysplastic kidneys, and 41 patients had unilateral obstruction with a normal contralateral kidney. In the latter group, 29 (71%) had good function (greater than 40%) at initial assessment. Of the 63 kidneys, 24 (38%) were operated upon following initial assessment, mainly for impaired function. Of 39 patients, initially managed non-operatively, 8 (21%) were operated upon subsequently: 3 for deteriorating function (2 of whom have been reassessed and both have regained their lost function) and 5 for other renographic or ultrasonic indications). Of the original 63 kidneys, 31 (49%) continue to be managed non-operatively; 16 of these (52%) show improving ultrasound appearances, 8 of 17 studied show improved drainage, and all unilateral cases have stable good function. It is concluded that non-operative management of selected cases of antenatally detected pelviureteric junction obstruction is safe.
我们报告了63例经肾图标准定义的产前检测到肾盂输尿管连接部梗阻的肾脏的随访数据（最短1年）。10例患者为双侧病变（即20个肾脏），2例患者为单侧梗阻伴对侧多囊性发育不良肾，41例患者为单侧梗阻伴对侧肾脏正常。在后一组中，29例（71%）在初始评估时肾功能良好（大于40%）。在63个肾脏中，24个（38%）在初始评估后接受了手术，主要是因为功能受损。在最初接受非手术治疗的39例患者中，8例（21%）随后接受了手术：3例因功能恶化（其中2例已重新评估，且均恢复了丧失的功能），5例因其他肾图或超声指征。在最初的63个肾脏中，31个（49%）继续接受非手术治疗；其中16个（52%）超声表现改善，17个接受检查的肾脏中有8个引流改善，所有单侧病例功能稳定良好。结论是，对产前检测到的肾盂输尿管连接部梗阻的部分病例进行非手术治疗是安全的。
