输尿管囊肿

From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术，其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症，将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较，对数据进行统计分析。

Methods Three hundred and fifty patients for laparoscopic surgery were admitted to our department from August 2001 to February 2002. They included 45 cases of adrenal glands surgery, 55 simple nephrectomy, 25 radical nephrectomy, 11 nephroureterectomy, 3 partial nephrectomy, 110 renal cyst decortication, 4 polycystic kidney decortication, 12 ureterolithotomy, 16 pyeloplasty, 3 retrocaval ureteroplasty, 58 varicocele-varix ligation and 8 pelvic lymph node dissection.

从2001年8月～2004年2月，350例患者施行了腹腔镜下泌尿外科手术，其中肾上腺手术45例，单纯肾切除55例，根治性肾切除25例，肾输尿管全切11例，肾部分切除3例，肾囊肿去顶术110例，多囊肾去顶减压术4例，输尿管切开取石术12例，UPJ成型术16例，腔静脉后输尿管成型术3例，精索静脉高位结扎术58例，盆腔淋巴结切除术8例。

Result:2 cases were made definite diagnosis among celiotomy exploratory, 1 case was diagnosed next day after injury, Another 3 cases weren't made definite diagnosis until 5～25 days later. 3 cases were taken ureter or ureter to renal pelvis end-to-end one-stage anastomosis early,2 cases were taken urinary cyst resection and ureter end-to-end anastomosis three months later,1 case performed extravsation of urine drainage only.

结果：2例在早期剖腹探查中明确诊断，1例于伤后d2明确诊断，另3例在伤后5～25d才明确诊断。3例早期行一期输尿管或输尿管肾盂端端吻合术，2例于损伤3个月后行尿液性囊肿切除输尿管端端吻合术，1例行单纯尿液引流。

The reconstruction with mip show that the percent of excellent was 67.2% and the worse was 32.8%.the accuracy of diagnosis respectively was 86.7%,50.0%,80.0%,77.8% and 50.0%.conclusion according to ureteral tract brightness,high image quality and high success rate with correctly reconstruction can delineate ureter cubicity,which is helpful in diagnosing and instructing clinical treatment.

mip显示：图像评级为优良39例(67.2%)，评级为差19例(32.8%)。疾病判断的准确度为：结石86.7%、肿瘤50.0%、囊肿80.0%、先天性狭窄77.8%、炎症50.0%。结论根据输尿管显像程度，选择合适的重建方法完整显示输尿管与疾病的解剖关系，有助于疾病的诊断和指导临床治疗。 x线计算机；输尿管造影；诊断；重建

There were no blood transfusion or serious complication in the study.Conclusions:Retroperitoneal laparoscopic operation,such as adrenalectomy,nephropexy,pelvioplasty,unroofing of renal cyst,pelvilithotomy,ureterdithotomy and spermatic vein ligation,have the advantages of minimai invasion,less blood loss and fewer complications,which is an effective and practical procedure.

后腹腔镜肾上腺瘤切除术、肾固定术、肾盂成形术、肾囊肿去顶术、肾盂或输尿管切开取石术及腹腔镜精索静脉高位结扎术具有创伤小、出血少、并发症少等优点，临床疗效可靠，实用性较强。

Results Of the 21 patients, 5 showed transplanted kidney swelling alone, 8 showed transplanted kidney swelling and perinephric dropsy, 1 showed atrophy and function failure of both kidney, 2 showed perinephric hemorrhage, 1 showed multiple small cysts, small calculi and perinephric dropsy of transplanted kidney, 1 showed ureteral fistula, ureteral stricture, hydronephrosis and infarct of subsegment kidney, 1 showed hydronephrosis and ureteral calculi, 1 showed swelling and pyonephrosis, and 1 showed rupture of transplanted kidney.

结果 21例患者中5例仅表现为移植肾肿胀，8例表现为移植肾肿胀并肾周积液；1例为双肾萎缩伴功能丧失；2例表现为移植肾周积血；1例表现为移植肾多发小囊肿、小结石并肾周积液；1例表现为移植肾输尿管旁尿瘘伴输尿管狭窄及肾积水、亚段肾梗死；1例表现为移植肾积水并输尿管结石；1例表现为移植肾肿胀，肾盂内积脓；1例表现为移植肾破裂。

Moreover, evaluation of the renal function and the ureterodynamics of the left ureter with ureterocle were achieved by calculation of the ureteric jet index through combined real-time and Doppler ultrasonography.

我们认为：合并实时间、彩色都卜勒和频谱都卜勒超音波术的检查，可用以施行输尿管末端囊肿的尿路动力学研究。

Keywords Ureterocele;Diagnosis;Treatment

输尿管囊肿；诊断；治疗

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。