肾盂输尿管连接部梗阻（PUJO）的保守治疗：是否合适，如果合适，需要随访多长时间？
Conservative management of pelvi-ureteric junction obstruction (PUJO): is it appropriate and if so what duration of follow-up is needed?
机构信息
Department of Urology, Sheffield Teaching Hospitals NHS Trust, Sheffield, UK.
出版信息
BJU Int. 2012 Aug;110(3):446-8. doi: 10.1111/j.1464-410X.2011.10779.x. Epub 2012 Jan 11.
OBJECTIVE
• To establish whether it is safe to manage minimally symptomatic and asymptomatic pelvi-ureteric junction obstruction (PUJO) conservatively.
PATIENTS AND METHODS
• In all, 50 patients with PUJO diagnosed with dynamic renography, and monitored with at least two renograms.
RESULTS
• 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.
CONCLUSIONS
• 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.
目的
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。
患者和方法
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。
结果
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。
结论
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。
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