Pugachev A G, Kudriavtsev Iu V, Pavlov A Iu, Osipov V P, Voronovitskiĭ V D
Urol Nefrol (Mosk). 1993 Jan-Feb(1):16-9.
The paper is concerned with disputable aspects of the policy in the diagnosis of neuromuscular ureteral dysplasia (NUD) in children, with indications to NUD conservative treatment and a choice of optimal surgical correction at primary or repeat operations basing on ureteral dilatation. The necessity of the NUD conservative treatment in children with nonaffected renal function has been confirmed by 52 cases of NUD children treated conservatively or surgically. The analysis of surgical outcomes in 34 NUD children and urodynamic pre- and postoperative examinations in 18 of them suggest the following conclusions: 1) the decision on "modelling" of the ureter is feasible only in the course of surgical intervention; 2) in ureteral dilatation less than 5-7 mm "modelling" is unnecessary. In other cases "modelling" is made at primary surgery according to Kalicinski's technique, at resurgery according to Hander. Positive outcomes in primary interventions were registered in 78% of the patients, 62% of the operations were successful in recurrent disease.
本文关注儿童神经肌肉性输尿管发育异常（NUD）诊断政策中存在争议的方面、NUD保守治疗的指征以及基于输尿管扩张情况在初次或再次手术时选择最佳手术矫正方法。52例接受保守治疗或手术治疗的NUD患儿证实了对肾功能未受影响的NUD患儿进行保守治疗的必要性。对34例NUD患儿的手术结果分析以及其中18例患儿术前和术后的尿动力学检查得出以下结论：1）输尿管“塑形”的决定仅在手术过程中可行；2）输尿管扩张小于5 - 7毫米时无需“塑形”。其他情况下，初次手术时根据卡利钦斯基技术进行“塑形”，再次手术时根据汉德技术进行“塑形”。初次干预中78%的患者取得了积极效果，复发性疾病手术成功率为62%。
