摘要目的 分析儿童肾积水肾盂收缩情况及与术后肾盂前后径(APD)改善程度(PI-APD)的相关性.方法 收集2015年10月至2017年9月于重庆医科大学附属儿童医院泌尿外科行腹腔镜下肾盂输尿管成形术的单侧肾盂输尿管连接处梗阻(UPJO)肾积水患儿,术中暴露肾盂后观察记录肾盂2 min收缩频率,术后1年随访APD并计算PI-APD.根据超声表现并参照胎儿泌尿外科协会(SFU)分级系统将肾积水分为轻度、中度和重度.采用方差分析比较不同肾积水程度之间的肾盂收缩频率和PI-APD,同时采用Pearson和Spearman相关性分析肾盂收缩频率及肾积水程度与PI-APD的相关性.结果 共纳入50例患儿,其中36例于术后1年获得随访.对不同肾积水程度之间的肾盂2 min收缩频率进行比较,结果发现不同肾积水程度之间的肾盂2 min收缩频率比较[轻度:(8.1 ± 3.3)次;中度:(6.3 ± 3.5)次;重度:(7.8 ± 3.9)次]差异无统计学意义(F＝0.65,P＝0.527);肾盂2 min收缩频率与术前肾积水程度及术后1年PI-APD均无相关性(均P＞0.05).术前肾积水程度与PI-APD呈正相关(r＝0.54,P＝0.001),重度肾积水的PI-APD(0.48 ± 0.29)显著高于轻度肾积水(0.21 ± 0.20)(P＝0.001).结论 对于儿童UPJO导致的不同程度的肾积水,腹腔镜下肾盂输尿管成形术术中观察到的肾盂收缩频率未见明显差异,且与术后PI-APD无相关性,术前肾积水程度与术后PI-APD呈正相关.

abstractsObjective To analyze the frequency of pelvis peristalsis in children with hydronephrosis and its correlation with postoperative percentage of improvement in anteroposterior diameter (PI－APD).Methods From Oc-tober 2015 to September 2017,the data of the children with unilateral ureteropelvic junction obstruction (UPJO)hydro-nephrosis who underwent laparoscopic pyeloplasty were collected,and their pelvis peristalsis frequencies of 2 min were recorded after exposing the pelvis,while the APD and PI－APD were followed 1 year posto-peratively.The degrees of hydronephrosis were divided into mild,moderate and severe according to the Society of Fetal Urology(SFU)classifica-tion system.ANOVA was used to compare the pelvis peristalsis frequency and postoperative PI－APD between different degrees of hydronephrosis.Spearman analysis was used to analyze the correlation between pelvis peristalsis frequency and degree of hydronephrosis.Meanwhile,Pearson test was used to analyze the correlation between pelvis peristalsis fre-quency,hydronephrosis degree and PI－APD.Results A total of 50 children were included,of which 36 patients got follow－up for 1 year postoperatively.Pelvis 2 min peristalsis frequency between different degrees of hydronephrosis [mild:(8.1 ± 3. 3)times;moderate:(6.3 ± 3.5)times;severe:(7.8 ± 3.9)times]had no significant difference (F＝0.65,P＝0. 527);no statistical correlation was observed between pelvis peristalsis frequency and degree of hydro-nephrosis or PI－APD (all P ＞0.05).Preoperative hydronephrosis degree was positively correlated with PI －APD (r＝0.54,P＝0. 001).PI－APD in severe hydronephrosis (0.48 ± 0.29)was significantly higher than that of mild hydronephrosis (0.21 ± 0.20)(P ＝0.001 ). Conclusions For children with different degrees of hydronephrosis caused by UPJO,there was no significant difference in the pelvis peristalsis frequency recorded during laparoscopic pyeloplasty.Pelvis peristalsis frequency recorded during surgery was not correlated with PI －APD,but preoperative hydronephrosis degree was positively correlated with postoperative PI－APD.