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儿童双级尿道阻塞:系统性审查突出诊断挑战和最佳外科手术策略
Olivia-Oana Stanciu1,2, Andreea Moga1,2, Radu Balanescu1,2
1Department of Paediatric Surgery and Orthopaedics, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.
Children (Basel, Switzerland)
|February 27, 2026
概括
在儿童中诊断出同时发生的尿管皮交点 (UPJ) 和尿管交点 (UVJ) 阻塞是具有挑战性的. 一个分阶段的,近位第一手术方法改善了结果和脏恢复.
科学领域:
- 儿科泌尿外科 儿科泌尿外科
- 外科手术的结果
- 诊断成像 诊断成像 诊断成像
背景情况:
- 侧尿结 (UPJ) 和尿结 (UVJ) 的阻塞是一种不常见的儿科疾病,通常被标准成像错过.
- 延迟诊断可能导致持续的水,反复的尿路感染和逐渐的损伤.
- 本综述讨论了双UPJ-UVJ阻塞儿童的诊断挑战,管理和结果.
研究的目的:
- 系统地审查和综合有关UPJ和UVJ同时阻塞的儿科患者诊断,治疗和治疗结果的当前证据.
- 确定有效的诊断途径和手术策略,以应对这种具有挑战性的疾病.
主要方法:
- 按照PRISMA 2020指南进行系统审查,在PROSPERO.中注册.
- 搜索了主要的数据库,对儿科患者进行了研究,确认了ipsilateral UPJ + UVJ阻塞.
- 提取了关于临床表现,诊断,成像,手术测序和结果的数据.
主要成果:
- 双重阻塞的术前诊断不常见;诊断通常发生在手术内或术后.
- 对比性皮色学 (逆行/前行) 在检测远部病理方面优于超声波学和利尿性瘤学.
- 阶段性,近端-第一修复 (例如,皮叶塑性) 是有效的,经常改善远端排水和减少对二次手术的需求.
结论:
- 双UPJ-UVJ阻塞仍然是儿科泌尿病学的诊断挑战,需要加强警和成像.
- 相比之下,皮叶和手术内评估有助于检测;一个分阶段的近位第一手术方法优化了排水和的恢复.
- 早期干预对脏结果至关重要,尽管长期数据和随访是必不可少的.
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