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目的探讨输尿管异位开口的诊断及治疗。方法回顾性分析32例异位输尿管开口患者的临床资料,采用B超检查28例,IVU29例,CT13例、MRU7例,膀胱镜检查13例,异位开口插管造影8例,膀胱尿道、阴道造影12例。对其临床特点、诊断及外科治疗方式进行分析。结果术前确诊28例(93.3%)。行单侧肾脏输尿管或上半肾输尿管切除各12例,输尿管膀胱再植术4例,分期行左、右输尿管膀胱再植、左掌长肌移植尿道括约肌成形1例,左上重复肾、输尿管切除及左下、右侧输尿管膀胱再植1例,未行手术2例。30例术后随访3-16年,效果良好。结论输尿管异位开口的诊断需结合病史、体检、B超、IVU、膀胱镜、CT、MRU等检查进行综合分析,必要时行腹腔镜检查。上半肾输尿管切除及输尿管膀胱再植是治疗输尿管异位开口合并上/下尿路畸形的有效方式。
Objective To investigate the diagnosis and treatment of ureter ectopic opening. Methods The clinical data of 32 patients with ectopic ureteral incision were analyzed retrospectively. Twenty-eight cases were diagnosed by B-ultrasound, including 29 cases of IVU, 13 cases of CT, 7 cases of MRU, 13 cases of cystoscopy, 8 cases of ectopic open cannulation, 8 cases of bladder urethra and vagina 12 cases of contrast. The clinical features, diagnosis and surgical treatment were analyzed. Results 28 cases were diagnosed preoperatively (93.3%). 12 cases of unilateral renal ureter or upper ureter resection in each case, 4 cases of ureteral bladder replantation, staged left and right ureter bladder replantation, left lobe muscle transplantation urethral sphincter formation in 1 case, left upper quadrant ureter, ureteral resection And left lower ureter bladder resection in 1 case, no surgery in 2 cases. 30 cases were followed up for 3-16 years, the effect is good. Conclusion The diagnosis of ureteropelvic opening should be combined with history, physical examination, B-ultrasound, IVU, cystoscopy, CT, MRU and other tests for comprehensive analysis, if necessary, laparoscopy. Upper half of the ureter and ureter resection ureter is the treatment of ectopic ureter open upper / lower urinary tract deformity is an effective way.