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Three points for the treatment of hydronephrosis

2017-03-05 14:05

(a) the treatment aims to relieve obstruction, improve renal function, relieve symptoms, eliminate infection, and repair as normal as possible

Anatomical structure. (two) estimated the age of treatment: infants should be handled as soon as possible, the young can be observed, if progress should be timely surgery, 50 ~ 60

More than 60 years of age should be considered early surgical treatment to maintain a healthy renal function. Estimation of renal function and obstruction: a. Retained at least 1/5 of normal kidney tissue

To maintain the life of the minimum function, such as non essential, as far as possible not to renal drainage, in order to prevent infection. B. For asymptomatic hydronephrosis without infection

Patients can be every 6 to 12 months with B ultrasound, CT and intravenous pyelography re examination, if no progress can be temporarily surgery. C. Ureteropelvic junction obstruction

Can cause stones, so in the removal of stones at the same time, it is necessary to detect the existence of the cause of the formation of stones. If there is a narrow, should be corrected at the same time. Intra renal

The estimation of renal pelvis surgery is more difficult than that of renal pelvis. The timing of surgery: bilateral hydronephrosis in bilateral hydronephrosis and no infection, can be the first place

On the one side of the poor function, the contralateral side is continuously compensated for the functional load. On the side of the plastic surgery kidney under certain stimulation to restore good. Yes

In patients with infection, it is appropriate to choose a serious side of the first operation, and should be as soon as possible on the side. If only a better side of the infection, should be given priority

Surgery to maximize the retention of renal function, control of infection, the other side in a stable condition after surgery. On the side of a good function of the kidney with renal pelvis

Water, but still plastic surgery to restore renal function, should first consider surgery. If the contralateral kidney has been damaged and has no function, it is necessary to be operated on the side of the kidney

Functional recovery, stable condition before deciding whether it was. (three) the way of treatment: 1, local treatment: for the lesions of the obstruction site available

The treatment of the solution, such as adhesion separation, fiber band cut off, vascular displacement and anastomosis, stone removal, etc.. For local compression caused by excessive ureter

When the local development is seriously damaged, the ureter should be resected and then anastomosed. 2, for obstruction has caused severe hydronephrosis, the need for drainage. Three

Plastic surgery: must master the key points of plastic surgery: make the pelvis and ureter anastomosis at the lowest point of the pelvis. The renal pelvis and ureter anastomosis should form

Funnel shape. Repair should be removed around the fiber, adhesion, scar tissue, but do not damage blood supply. The resection of the pelvic wall excess, maintain a certain renal pelvis

Tension。 Such as hydronephrosis is too large, it can be thinner renal cortex at the varus folded after fixation, in order to reduce the volume of the kidney. In order to reduce the anastomotic leakage of urine, can be arranged

Double pigtail catheter. In order to avoid the leakage of urine and hemolytic stagnation formed around the anastomosis scar fibrosis, can be placed in the negative pressure suction tube anastomosis was full

Drainage. A lot of the plastic surgery, but the etiology and pathology angle think to resection and anastomosis for better disease.

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