Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
BJU Int. 2012 Aug;110(3):446-8. doi: 10.1111/j.1464-410X.2011.10779.x. Epub 2012 Jan 11.
• To establish whether it is safe to manage minimally symptomatic and asymptomatic pelvi-ureteric junction obstruction (PUJO) conservatively.
• In all, 50 patients with PUJO diagnosed with dynamic renography, and monitored with at least two renograms.
• In all, 19 patients were totally asymptomatic, while 31 patients had minimal symptoms at time of diagnosis. • The mean follow-up was 53 months. • During the course of follow-up 10 of the 50 patients deteriorated. • All patients who had asymptomatic renographic deterioration, deteriorated within 2 years of diagnosis. • Eight of the 10 patients that deteriorated needed pyeloplasty and two nephrectomy.
• Conservative management of patients with minimally symptomatic and asymptomatic PUJO is safe. • Discharging patients could be considered at 2 years from diagnosis, if they remain renographically stable and asymptomatic or minimally symptomatic.
探讨对轻度症状和无症状的肾盂输尿管连接部梗阻(PUJO)采取保守治疗是否安全。
共有 50 名经动态肾造影诊断为 PUJO 并至少进行了两次肾造影监测的患者纳入本研究。
所有患者中,19 名患者完全无症状,而 31 名患者在诊断时仅有轻微症状。平均随访时间为 53 个月。在随访过程中,50 名患者中有 10 名病情恶化。所有无症状肾造影恶化的患者均在诊断后 2 年内恶化。10 名病情恶化的患者中有 8 名需要肾盂成形术,2 名需要肾切除术。
对轻度症状和无症状的 PUJO 患者采取保守治疗是安全的。如果患者在诊断后 2 年内肾造影稳定且无症状或仅有轻微症状,可以考虑出院。