Basle M, Renier J C, Rebel A, Kerjean J
Sem Hop. 1980;56(5-6):238-44.
Surgical anastomosis of the ureter in the sigmoid could lead to osteomalacia. The pathogenesis of this disease is rather complicated and involves several factors, the most important of which is hyerchloremic acidosis associated with modifications of transport across the intestinal lining, and in particular, the elimination of bicarbonates and the reabsorption of H+ ions. This systemic acidosis makes the calcium balance negative by mobilizing calcium bicarbonate from bone and possibly by inhibiting alkaline phosphatase activity. The role of PTH and vitamin D has yet to be satisfactorily explained. The authors present cases of osteomalacia following two uretero-sigmoidostomies, one for bladder exstrophy and the other after bladder removel for tumour. The physiopathological mechanisms of osteomalacia are briefly recalled together with indications of treatment.
输尿管与乙状结肠的外科吻合术可能导致骨软化症。这种疾病的发病机制相当复杂，涉及多个因素，其中最重要的是与肠道黏膜转运改变相关的高氯性酸中毒，特别是碳酸氢盐的消除和氢离子的重吸收。这种全身性酸中毒通过从骨骼中动员碳酸氢钙并可能通过抑制碱性磷酸酶活性使钙平衡呈负值。甲状旁腺激素和维生素D的作用尚未得到令人满意的解释。作者介绍了两例输尿管乙状结肠吻合术后发生骨软化症的病例，一例是膀胱外翻，另一例是因肿瘤切除膀胱后发生的。简要回顾了骨软化症的生理病理机制以及治疗指征。
