先天性输尿管狭窄

泌尿外科医学英文名词n泌尿外科医学名词（Medical Word in Urology）中文名英文名泌尿外科学urology孤立肾Solitary kidney重复肾Renal duplication, duplex kidney游走肾Movable kidney肾静脉栓塞Thrombosis of renal vein肾动脉狭窄Stenosis of renal artery单纯肾囊肿Simple cyst of kidney先天性肾囊性疾病Congenital renal cystic disease肾盂旁囊肿Parapelvic cyst肾损伤Injury of kidney肾裂伤Laceration of kidney肾蒂断裂Rupture of renal pedicle肾积水Hydronephrosis肾脓肿Renal abscess临床肾结核Clinical renal tuberculosis腔内泌尿外科学Endourology肾畸形Deformity of kidney马蹄形肾Horseshoe kidney肾下垂Nephroptosis肾外型肾盂Extrarenal pelvis肾旋转异常Renal malrotation肾动静脉瘘Renal arteriovenous fistula肾动脉栓塞Thrombosis of renal artery肾囊肿Cyst of kidney多囊肾Polycystic kidney肾挫伤Contusion of kidney肾破裂Rupture of kidney肾穿透伤Penetrating injury of kidney肾梗塞Renal infarction巨大肾积水Giant hydronephrosis肾积脓pyonephrosis病理性肾结核Pathological renal tuberculosis肾结核对侧肾积水Renal tuberculosis with Controlateral hydronephrosis 海绵肾Medullary sponge kidney肾肿瘤Tumor of kidney肾皮质腺瘤Renal cortical adenoma肾盂乳头状瘤Papilloma of renal pelvis肾实质癌Carcinoma of renal parenchyma肾透明细胞癌Clear cell carcinoma of kidney肾腺癌Adenocarcinoma of kidney肾鳞状细胞癌Squamous cell carcinoma of renal pelvis肾切开术Nephrotomy肾盂切开术Pyelotomy肾切除术Nephrectomy经皮肾造瘘术Percutanous nephrostomy肾造瘘术Nephrostomy根治性肾切除术Radical nephrectomy肾盂输尿管松解术Pelvioureterolysis腹膜后淋巴结切除术Retroperitoneal lymphadenectomy肾动脉栓塞术Embolization of renal artery肾鹿角状结石Staghorn stone of kidney肾萎缩Renal atrophy输尿管扩张Dilatation of ureter巨输尿管Megaloureter输尿管畸形Deformity of ureter重复肾盂Duplication of pelvis输尿管开口异位Ectopia of ureteral orifice腔静脉后输尿管Retrocaval ureter输尿管脱垂Ureterocele正常位输尿管膨出Orthotopic ureterocele肾血管平滑肌脂肪瘤Hamartoma of kidney，Angiomyolipoma 肾良性肿瘤Binign renal tumor肾脂肪瘤Lipoma of kidney肾纤维瘤Renal fibroma肾腺瘤Adenoma of kidney肾盂移行细胞癌transitional cell carcinoma of renal pelvis 肾盂肿瘤tumor of renal pelvis肾癌renal carcinoma肾细胞癌renal cell carcinoma肾颗粒细胞癌granular cell carcinoma of kidney肾母细胞瘤wilms tumor，nephroblastoma肾肉瘤sarcoma of kidney肾盂癌carcinoma of renal pelvis肾盂乳头状癌papillary carcinoma of renal pelvis肾切开取石术nephrolithotomy肾盂切开取石术pyelolithotomy肾-肾盂造瘘术nephropyelostomy肾部分切除术partial nephrectomy肾盂造瘘术pyelostomy肾自截autonephrectomy包膜下肾切除术subcapsular nephrectomy肾输尿管切除术nephro-ureterectomy肾固定术nephropexy剖腰探查术exploratory lumbotomy重复输尿管duplication of ureter输尿管积水hydroureter输尿管损伤injury of ureter输尿管瘘ureteral fistula输尿管结核tubculosis of ureter输尿管乳头状瘤papilloma of ureter输尿管移行细胞癌transitional cell carcinoma of ureter输尿管切开术ureterotomy输尿管松解术ureterolysis输尿管造瘘术ureterostomy输尿管-肠-皮肤尿流改道术uretero-enterocutaneous diversion 离断性肾盂输尿管成形术dismembered ureteropelvioplasty输尿管肾盂吻合术ureteroneopyelostomy输尿管切除术ureterectomy输尿管输尿管吻合术ureteroureterostomy阑尾输尿管成形术appendix ureteroplasty输尿管移植术transplantation of ureter输尿管梗阻ureteral obstruction肾盂输尿管交界处狭窄stricture of uretero-pelvic junction 输尿管痛ureteral colic膀胱憩室diverticulum of bladder膀胱挫伤contusion of bladder腹膜内膀胱破裂intraperitoneal rupture of bladder膀胱瘘vesical fistula细菌性膀胱炎bacterial cystitis膀胱结核tuberculosis of bladder膀胱嗜铬细胞瘤pheochromocytoma of bladder膀胱乳头状癌papillary carcinoma of bladder输尿管肾盂交接处梗阻obstruction at ureteropelvic junction 先天性巨输尿管congenital megaloureter反流性巨输尿管reflux megaloureter输尿管肠瘘uretero-enteric fistula输尿管肿瘤tumor of ureter输尿管癌carcinoma of ureter输尿管乳头状癌papillary carcinoma of ureter输尿管皮肤造瘘术cutaneous ureterostomy输尿管切开取石术ureterolithotomy输尿管口切开术ureteral meatotomy输尿管回肠皮肤尿流改道术ureteroileal cutaneous diversion输尿管回肠吻合术ureterosigmoidostomy，ureterosigmoid anastomosis输尿管结肠吻合术uretero-colic anastomosis输尿管膀胱吻合术ureteroneocystostomy输尿管皮肤尿流改道术uretero-cutaneous diversion输尿管结石calculus of ureter输尿管狭窄stricture of ureter输尿管口狭窄stricture of uretero-vesical orifice膀胱输尿管反流vesicoureteral reflux膀胱损伤injury of bladder膀胱破裂rupture of bladder膀胱腹膜外破裂extraperitoneal rupture of bladder膀胱阴道瘘vesicovaginal fistula膀胱肿瘤tumor of bladder膀胱乳头状瘤papilloma of bladder膀胱癌carcinoma of bladder膀胱原位癌bladder carcinoma in situ膀胱移行细胞瘤transitional cell carcinoma of bladder膀胱鳞状细胞瘤squamous cell carcinoma of bladder膀胱腺癌adenocarcinoma of bladder膀胱憩室内结石calculus in diverticulum of bladder经尿道膀胱颈切开术transurethral vesical neck incision耻骨上膀胱造口术suprapubic cystostomy膀胱憩室切除术vesical diverticulectomy膀胱切除术cystectomy膀胱全切除术total cystectomy膀胱尿道吻合术vesicourethral anastomosis膀胱灌注irrigation of bladder经尿道膀胱肿瘤切除术transurethral resection of bladder tumor回肠膀胱术ileal conduit, Bricker operation乙状结肠膀胱扩大术sigmoid augumentation cystoplasty回肠膀胱尿流改道术ileal conduit diversion髂腹股沟淋巴结切除术ilioinquinal lymphadenectomy膀胱异物foreign body in bladder膀胱孪缩contracture of bladder尿道口狭窄meatal stenosis尿道下裂hypospadias尿道损伤injury of urethra尿道瘘urethral fistula尿道直肠瘘urethro-rectal fistula尿道阴道瘘urethro-vaginal fistula神经源性膀胱neurogenic bladder尿道机械性梗阻mechanical obstruction of urinary tract尿道综合症urethral syndrome非淋菌性尿道炎non-gonococcal urethritis衣原体性尿道炎chlamydial urethritis尿道尖锐湿疣condylomata acuminata of urethra尿道肉阜urethral caruncle尿道息肉polyp of urethra尿道球腺囊肿cyst of cowper gland尿道癌carcinoma of urethra膀胱肉瘤sarcoma of bladder膀胱结石vesical calculus耻骨上膀胱穿刺吸引术suprapubic needle aspiration of bladder耻骨上膀胱切开取石术suprapubic cystolithotomy膀胱切开取石术cystolithotomy, cystolithectomy膀胱部分切除术partial cystectomy根治性膀胱切除术radical cystectomy可控性回肠膀胱术continent ileal reservoir, kock pouch经皮膀胱造口术percutanous cystostomy尿流改道术diversion of urine, urinary diversion回肠膀胱扩大术Ileum augmentation cystoplasty，ileo-cystoplasty 膀胱前列腺切除术cystoprostatectomy尿道狭窄urethral stricture尿道瓣膜urethral valve尿道憩室urethral diverticulum尿道皮肤瘘urethrocutaneous fistula尿道皮肤瘘urethrocutaneous fistula尿道瘘urinary fistula尿道异物foreign body in urethra尿道结石calculus of urethra压力性尿失禁stress incontinence神经性膀胱nervous bladder尿道探子urethral sounding尿道炎urethritis细菌性尿道炎bacterial urethritis淋菌性尿道炎gonococcal urethritis尿道结核tuberculosis of urethra尿道肿瘤tumor of urethra尿道口切开术urethral meatotomy经尿道尿道瓣膜切除术transurethral resection of urethral valve尿道膀胱固定术urethrovesicopexy经尿道外括约肌切开术transurethral sphincterotomy尿道会师术reconstruction of ruptured urethra by Bank method 尿道狭窄扩张术dilatation of urethral stricture尿道切除术urethrectomy尿道内切开术internal urethrotomy肾上腺切除术adrenalectomy皮质醇增生症hypercortisolism经尿道前列腺切除综合症transurethral prostatic resection syndrome慢性前列腺纤维化chronic fibrosis of prostate前列腺炎prostatitis前列腺肿瘤tumor of prostate前列腺腺癌adenocarcinoma of prostate前列腺癌carcinoma of prostate前列腺切除术prostatectomy耻骨后前列腺切除术retropubic prostatectomy经尿道前列腺切开术transurethral incision of prostate电切镜resectoscope泌尿生殖隔urogenital diaphragm尿路上皮urothelium尿路梗阻urinary tract obstruction泌尿生殖器外伤genitourinary trauma尿道成形术urethroplasty尿道口成形术urethral meatoplasty压力性尿失禁悬吊术sling procedure for stress incontinence尿道口前移头成形术meatal advancement and glandular plasty 尿道前移术urethral advancement嗜铬细胞瘤pheochromocytoma原发性醛固酮增生症primary aldosteronism肾上腺非功能性皮脂腺瘤nonfunctional adrenocortical adenoma前列腺增生症hyperplasia of prostate前列腺按摩message of prostate细菌性前列腺炎bacterial prostatitis淋菌性前列腺炎gonococcal prostatitis耻骨上前列腺切除术suprapubic prostatectomy经尿道前列腺切除术transurethral prostatic resection根治性前列腺切除术radical prostatectomy尿路上皮肿瘤urothlial tumor尿路感染urinary tract infection泌尿生殖系统urogenital system精液囊肿seminal cyst, spermatocele精索扭转torsion of spermatic cord精索静脉曲张varicocele精囊炎seminal vesiculitis输精管结核tuberculosis of vas deferens精囊切除术seminal vesiculectomy输精管结扎术vasoligation输精管输精管吻合术vasovasostomy阴囊挫伤contusion of scrotum阴囊肿瘤tumor of scrotum睾丸鞘膜积液hydrocele of testis先天性鞘膜积液congenital hydrocele混合型鞘膜积液combination hydrocele脐尿管urachus脐尿管瘘fistula of urachus脐尿管囊肿urachal cyst脐尿管疾病dieases of urachus脐尿管癌carcinoma of urachus包茎phimosis小 micropenis挫伤contusion of penis输精管切除术vasectomy精液囊肿切除术spermatocelectomy生殖器疱疹genital herpes交通性鞘膜积液communicating hydrocele阴囊血肿hematoma of scrotum脐尿管腺癌adenocarcinoma of urachus折断fracture of penis嵌顿包茎paraphimosis损伤injury of penis血肿hematoma of penis包皮变应性水肿allergic edema of prepuce包皮垢smegma勃起erection of penis纤维性海绵体炎fibrous cavernositis of penis 血管瘤penile angioma癌carcinoma of penis鳞状细胞瘤squamous cell carcinoma of penis 包皮背侧切开术dorsal slit of prepuce切除术penectomy再造术reconstruction of penis睾丸发育不全hypoplasia of testis睾丸下降不全incomplete orchiocatabasis回缩睾丸retracted testis克兰费尔特综合症klinefelter syndrome睾丸萎缩atrophy of testis睾丸挫伤contusion of testis死精症necrospermia睾酮testosterone阳萎impotence睾丸炎orchitis腮腺炎性睾丸炎mumps orchitis睾丸精原细胞瘤seminoma of testis睾丸非生殖细胞瘤non-germinal cell tumor of testis睾丸生殖细胞瘤germinal cell tumor of testis睾丸癌carcinoma of testis睾丸畸胎瘤teratocarcinoma of testis睾丸绒毛膜瘤choriocarcinoma of testis睾丸切除术orchiectomy附睾炎epididymitis附睾肿瘤tumor of epididymis包皮过长redundant prepuce肿瘤tumor of penis癌前期病precancerous lesion of penis鳞状细胞瘤squamous cell carcinoma of penis包皮环切术circumcision截断术amputation of penis人工 penile prosthesis睾丸附件testicular adnexa隐睾症cryptorchidism睾丸损伤injury of testis早泄prospermia，premature ejaculation血管性阳痿vasculogenic impotence附睾睾丸炎epididymo-orchitis睾丸肿瘤tumor of testis非精原细胞瘤non seminoma睾丸畸胎瘤teratoma of testis睾丸胚胎癌embryonal carcinoma of testis附睾结核tubculosis of epididymis附睾腺瘤adenoma of epididymis遗尿症enuresis尿流中断interruption of urinary stream排尿困难difficulty of urination漏尿leakage of urination充溢性尿失禁overflow incontinence尿末滴沥terminal dribbling尿毒症uremia男性泌尿生殖系结核tuberculosis of male genital-urinary system 肾血管性高血压renal vascular hypertension血性精液hemospermia无精子症azoospermia逆行射精retrograde ejaculation不育sterility尿流率测定uroflometry尿道抬举试验marshall-marchetti test经尿道活检transurethral biopsy经会阴活检transperineal biopsy排泄性尿路造excretory urography,intravenous pyelography 肾盂输尿管造影术pyeloureterography肾血管造影术renal angiography经皮肾动脉造影术seldinger technique of renal angiography肾静脉造影术renal venography顺行肾盂造影术antegrade pyelography肾盂镜检查术pyeloscopy输尿管镜检查术ureteroscopy逆行膀胱造影术retrograde cystography排泄性膀胱造影术excretory cystography附睾切除术epididymectomy夜间遗尿症nocturnal enuresis排尿反射micturition reflex排尿犹豫hesitancy in urination尿外渗urinary extravasation假性尿失禁false incontinence女性尿失禁female incontinence剩余尿residual urine结晶尿crystalluria肾小球性血尿glomerular hematuria排尿指数micturition index遗精nocturnal emission精子减少[症] oligospermia手淫masturbation泌尿外科检查urologic examination尿流动力学检查urodynamic study膀胱测压cystometry夜间勃起试验nocturnal penile tumescence test经直肠活检transrectal biopsy尿道造影[术] urography逆行肾盂造影术retrograde urography，retrograde pyelography 肾动脉造影术renal arteriography选择性肾动脉造影术selected renal arteriography经股静脉插管transfemoral catheterization of femoral vein腹主-肾动脉造影术abdominal aorto-renal arteriography经尿道输尿管肾盂镜检查术transurethral ureteropeyloscopy输尿管肾镜ureterorenoscope输尿管肾盂造影术ureteropyelography膀胱造影术cystography膀胱尿道造影术cysto-urethrography膀胱冲洗法bladder washout method膀胱镜cystoscope逆行尿道造影术retrograde urethrography尿道镜urethroscope导尿术urethral catheterization，catheterization输精管造影术vasography海绵体造影术cavernosography肾图renography液电碎石术electrohydraulic lithotripsy经皮肾镜取石术percutaneous nephrolithotomy性行为sexual behavior性功能sexual function男性不育症male infertility精液semen高肾素型高血压high renin hypertension多尿型肾衰竭polyuric renal failure去梗阻后利尿postobstructive diuresis体外动静脉短路external arterio-venous shunt绒毛膜促性腺激素chorionic-gonodotropin hormone动力性尿路梗阻dynamic obstruction of urinary tract腹股沟疝inguinal hernia膀胱镜cystoscopy尿道造影术urethrography排泄性尿道造[术] excretory urethrography尿道膀胱造影[术] urethrocystography尿道镜检查[术] urethroscopy间歇性导尿intermittent catheterization淋巴系造影[术] lymphography输精管精囊造[术] vaso-seminal vesiculography输精管附睾造影[术] vasoepididymography精囊造影[术] seminal vesiculography附睾造影[术] epididymography超声碎石术ultrasonic lithotripsy体外冲击波碎石术extracorporeal shock-wave lithotripsy 性活动sexual activity精子spermatozoon男性性功能障碍male sexual dysfunction性腺功能减退症hypogonadism少尿型肾衰竭oliguric renal failure渗透性利尿osmotic diuresis组织相容性试验histocompatibility test性染色体sex chromosome射精ejaculation特发性腹膜后纤维化idiopathic retroperitoneal fibrosis细胞调亡apoptosis腹膜后纤维化retroperitoneal fibrosis憩室diverticulum动静脉瘘arteriovenous fistula剖腹探查术exploratory laparotomy冷冻疗法cryotherapy畸胎瘤teratoma肾盂输尿管连接部狭窄stricture of pyeloureteric junction 孤立性肾囊肿solitary renal cyst闭合伤closed injury肾移植renal transplantation肾上腺移植adrenal transplantation组织相容性histocompatibility超急性排斥反hyperacute rejection慢性排斥反应chronic rejection单克隆抗体monoclonal antibody麻醉anesthsia白细胞介素Interleukin尸体肾移植cadaveric renal transplantation疤痕scar端侧吻合术end-to-side anastomosis息肉polyp腹腔镜检查术laparoscopy错构瘤hamartoma重肾双输尿管duplication of kidney and ureter合并伤associated injury器官移植organ transplantation急性肾小管坏死acute tubular necrosis睾丸移植testis transplantation排斥反应rejection急性排斥反应acute rejection免疫抑制immunosuppression多克隆抗体polyclonal antibody感染infection乳头状瘤papilloma端端吻合术end-to-end anastomosis。

CTU在输尿管梗阻鉴别诊断中的应用作者：万林伍忠根郭珍珍等来源：《中国现代医生》2013年第33期[摘要] 目的探讨CTU在输尿管梗阻中的诊断价值。

方法分析本院60例输尿管梗阻患者CTU图像，确定其梗阻原因并与术后病理及临床诊断比较。

结果引起梗阻UPJO 5例，结石45例，结核3例，肿瘤3例，输尿管囊肿1例，炎性狭窄2例，医源性狭窄1例，其中一例术前诊断为炎性狭窄，术后病理为肿瘤。

结论 CTU对于输尿管狭窄有很好的诊断价值，可以评估肾脏分泌功能，能为临床提供大量信息。

[关键词] CT尿路成像（CTU）；输尿管梗阻；鉴别诊断[中图分类号] R691.2 [文献标识码] B [文章编号] 1673-9701（2013）33-0091-03输尿管梗阻是泌尿科中最常见的疾病，引起输尿管梗阻的原因很多，对于临床医生来说输尿管梗阻的部位及原因极为重要，对于临床下一步治疗至关重要。

以前此类患者影像检查就是彩超、IVP、逆行造影、MRU检查；随着CT技术的发展，临床上应用越来越广泛，本文探讨CTU在输尿管狭窄中的价值。

1 资料与方法1.1 一般资料选取本院2012年1月～2013年6月60例B超检查输尿管梗阻患者，其中B超梗阻原因不明15例，男35例，女25例，年龄12～63岁，临床症状腰痛、腰部肿块、血尿、尿路刺激症。

均行CTU检查。

1.2 方法60例患者肾功能均正常，采用西门子SOMATOM Sensation 16螺旋CT扫描，患者当日禁食，取仰卧位，膀胱充盈状态，扫描范围从肾上极至膀胱下缘，平扫后再用高压注射器自前臂静脉注入碘海醇约80～100 mL、注射速率（3～4） mL/s，扫描参数：管电压120 kV、管电流80～220 mA、动脉期30 s、实质期100 s、延迟期5 min，如肾积水严重患者5 min肾集合系统未见显影可适当延长直至其显影；将原始图像传至工作站处理，重建方法包括多平面重组（multiplanar reconstruction，MPR）、曲面重建（curved planar recon strution，CPR）、容积再现（volume reconstruction，VR）、最大密度投影（Maximum intensity projection，MIP）。

同种异体脱细胞真皮基质修复输尿管狭窄的临床应用(附11例报告)李文华1刘乃波2方自林2臧美孚3[摘要] 目的:探讨新型替代材料 同种异体脱细胞真皮基质修复输尿管狭窄的临床经验,寻求理想的输尿管替代材料。

方法:采用天然细胞外基质 同种异体脱细胞真皮基质修补治疗输尿管长段狭窄11例。

男5例,女6例。

平均年龄44 5岁。

病程12~39个月,平均20 5个月。

其中肾盂输尿管移行区狭窄5例,输尿管中上段狭窄3例,输尿管下段狭窄3例。

狭窄长度3~10cm 。

结果:11例随访6~65个月,中位随访时间为19 5个月。

术后4周拔除输尿管支架管4例,术后8周拔除支架管7例。

术后6个月IV U 检查:9例输尿管造影剂通过正常,无狭窄,无渗漏;2例术后出现再狭窄,狭窄段约1cm 、1 5cm,二次行输尿管成形术治愈。

结论:同种异体脱细胞真皮基质为机体提供了良好的供宿主细胞 爬行替代 的框架,在修补后可有效地与宿主组织融合,修补后的输尿管愈合良好。

同种异体脱细胞真皮基质作为输尿管修复材料,无排斥等不良反应,适合于长段的输尿管狭窄或缺损,是较理想的输尿管替代材料。

[关键词] 输尿管狭窄;细胞外基质;移植[中图分类号] A [文献标识码] R693 2 [文章编号] 1001 1420(2008)07 0516 03A cellu lar dermal matrix allograft for the reconstruction of ureter(Report of 11cases)L I Wenhua 1 LI U naibo 2 F AN G z ilin 2 ZAN G meif u 3(1Postgradute Institute of Peking Unio n M edical Co lleg e,Beijing,100073,China;2Department of U rolo gy,China Japan Fr iendship H ospital;3Department of U rolog y,Peking Union Medical Colleg e H ospital,Chinese Academy of m edical Sciences)Abstract Objective:T o evaluate the po ssibilit y o f allodecellular ex tracellular matr ix (ECM ) acellular der mal matr ix allog raft (AD M A)for the reconstruction of ur eter and fo und an idea l r eplacement mater ial to sim plify the ureter oplastic surg ery.Methods:A DM A w as used to treat t he str icture of ur eter in 11pat ients(male 5and female 6;mean age,44.5y ears).T he mean disease co ur se w as 20.5months(rang e,12(39mo nths).Of t he 11cases,5had str ictur e of pelv iureter ic transition zone;3had str icture o f upper and middle ur eter;3had st ricture of lo wer ur et er.T he str ictur e lenth ranged fro m 3to 10cm.Results:T he procedur e w as per for med successfully at one stag e in 11cases w ithout complication.T he 11cases w ere follo wed up for 6mo nt hs to 65months(median,19.5mo nths).P ostoperatively ,the ureter stents wer e remov ed in 4cases at 4weeks and in other 7cases at 8w eeks.T he ureter functions o f 9patients wer e no rmal aft er operation.N o stenosis,effusion and hydro nephro sis wer e o bser ved o n IV U 6months after o per at ion.U reteral st ricture dev elo ped ag ain in 2cases and o per ation was perfor med aga in and succeed.Conclusions:A DM A can pr ov ide a fr ame fo r t he host cells g ro wth,and it can be mixed w ith ho st tissues to pro vide a go od intensiv e po tency ,so it might be an ideal tissue eng ineer ing mater ial for t he r eplacement of ur et er.Key words U reter al str ictur e;Ex tracellular matrix ;T ransplantatio n1中国协和医科大学研究生院(北京,100073)2中日友好医院泌尿外科3中国医学科学院北京协和医院泌尿外科[通讯作者]李文华(E mail:liw enhua361@)2002年7月~2007年11月,我们应用北京清源伟业生物组织工程科技有限公司和北京桀亚莱福生物有限公司提供的组织工程学材料天然细胞外基质(ex tr acellular matrix,ECM) 同种异体脱细胞真皮基质(acellular dermal matr ix allo graft,ADM A)[国食药监械(准)2004第3460736号、国食药监械(准)2006第3460430号]作为输尿管替代材料治疗输尿管长段狭窄11例,效果满意。

泌尿系统彩色多普勒肾积水轻度肾积水患者由于肾内血流丰富,经保守治疗后预后尚好。

中度积水时肾内血流减少,CDE呈边缘缺损,经过一段时间的药物治疗,梗阻解除后肾功能可恢复。

重度积水时肾内血流明显减少,CDE呈斑点形或无血流型,肾动脉血流速度呈低流高阻型,实验室检查尿素氮升高明显。

如不立即解决梗阻,很快进人急性肾功能衰竭的病理阶段,且不可逆。

肾积水是由于尿路被某些病变堵塞,排尿不畅,梗阻的上尿路扩张至肾盂肾盏,随着管腔压力增高,肾小球滤过及肾小管的重吸收功能受到影响,轻度病变管壁肌的蠕动加强,尚能部分克服梗阻,肾脏还能维持其生理功能。

当堵塞仍未解除时管腔内压力急剧升高,使管壁的血供减少,使肾脏大面积缺血,肾小球滤过压下降,滤过率减少,尿素氮、肌配等有毒的代谢产物排出障碍,这种尿路梗阻引起的肾功能损害如果持续7天以上得不到解除,可导致肾脏的不可逆性损伤—急性肾功能衰竭.[1]输尿管梗阻输尿管位于腹膜外位的肌性管道,长约20～30cm,上端起自肾盂,终于膀胱。

管腔自上至下逐渐变细,平均为0.5～1.0cm，最窄处口径只有0.2~0.3。

输尿管全长分为腹部、盆部和壁内部。

[2]输尿管梗阻是临床上常见的征象。

输尿管结石是输尿管梗最常见的原因。

彩超检查可直观准确地显示扩张的输尿管,并能追踪扫查发现病变,明确梗阻原因。

因不同梗阻病因的组织结构不同,其声像图表现也不同,各种原因引起的输尿管梗阻,绝大部分患者梗阻部位以上的输尿管扩张,直径在7mm以上。

各种梗阻原因的诊断要点如下①输尿管结石:输尿管腔内见团状强回声,与管壁分界清楚,其后伴声影,部位多发生在输尿管狭窄部,尤以第三狭窄部最多见,结石部位以上输尿管扩张伴合并肾盂积水,完全梗阻时患侧输尿管开口处无喷尿现象;输尿管与周围组织的解剖关系，尤其是肠气的关系，使不伴有输尿管积水的结石，超声显示较困难，较小的结石有时又无声影或声影不明显，检查时必须仔细辨认，发现肾积水时，操作一定要耐心，前后、左右、上下多方位扫查提高输尿管结石诊断。