兒童時期併存的膀胱輸尿管逆流及腎盂輸尿管交接處陰塞

The Coexistance of Vesicoureteral Reflux and Ureteropelvic Junction Obstruction in Children

蔡淳娟(Tsuen-Chiuan Tsai) ； 黃富源(Fu-Yuan Huang) ； 張北葉(Pei-Yeh Chang) ； 許錦城(Chin-Chen Hsu) ； 張奐光(Huan-Koan Chang) ； 陳秋江(Chiu-Chiang Chen)

《Acta Paediatrica Sinica》 33卷4期 (1992/08) Pp. 273-279

摘要

輸尿管內尿逆流和腎盂輸尿管交接處狹窄，是很常見的兒童泌尿道畸型，偶而兩者可同時發生，並且常造成診斷及治療上的困難。本文收集1982年l月至1990年12月間，共229個（337條輸尿管）輸尿管內尿逆流病例，其中12例（13條輸尿管，佔3.86%）同時存在腎盂輸尿管交接處狹窄，我們依治療的觀點，將其分為三組：兩條屬第Ⅰ組，只需腎盂造形術；兩條屬第Ⅱ組，需腎盂造形術及輸尿管再植入術；第三組為輸尿管內尿逆流合併“偽”腎盂輸尿管交接處狹窄，原有9條，先以內科療法追蹤，後來2條轉變成腎盂輸尿管交接處完全阻塞，而需手術治療。本文強調對於腎盂過度擴張的輸尿管尿逆流病例，需仔細評估其腎盂輸尿管交接處之阻塞程度，以避免不必要的輸尿管再植入術，或因為不適當的開刀順序，而造成併發症。

並列摘要

From January 1982 to December 1990, there were 229 cases with 337 ureters having vesicoureteral reflux (VUR). Thirteen of them (3.86%) were also found to have ureteropelvic junction (UPJ) obstruction in the same ureter. They were categorized into three groups based on the therapeutic implications. Group 1 (two ureters) underwent pyeloplasty. Group 2 (two ureters) received both pyeloplasty and reimplantation. The remaining nine ureters having VUR and pseudo-obstruction fell into group 3, and two of them became true UPJ obstruction eventually. We stressed the importance of evaluating upper urinary tract in all refluxed ureters with inappropriately dilated renal pelvis. By doing that we can avoid unnecessary surgery and prevent complications from wrong sequence of operation to a least extent.

並列關鍵字

vesicoureteral reflux ； ureteropelvic junction obstruction