【摘要】 目的 探討多層螺旋CT低劑量掃描在小兒上尿路梗阻性疾病中的應用價值?！》椒ā?008年1月-2009年6月經(jīng)臨床手術(shù)證實尿路梗阻的患兒52例，按梗阻的原因分為結(jié)石組13例與非結(jié)石組39例。將非結(jié)石組患兒，按照年齡分為0~1歲（8例）、1~5歲（16例）和5~10歲（15例）3個組，均采用個性化的低劑量掃描方式?！〗Y(jié)果 結(jié)石組與非結(jié)石組陽性診斷率均為100%。低劑量掃描患兒所接受的輻射劑量明顯降低，CT掃描管電流不變，管電壓降低1/3，CT檢查的輻射劑量可降低約70%，且均可達到臨床診斷要求?！〗Y(jié)論 多層螺旋CT低劑量個性化掃描在小兒上尿路梗阻性疾病中診斷中具有明顯優(yōu)勢?！続bstract】 Objective To evaluate low-dose multislice spiral CT for upper urinary tract obstruction in children. Methods From January 2008 to June 2009, 52 children with upper urinary tract obstruction were diagnosed via clinical surgeries. The patients were divided into two groups according to whether having renal calculus (13 patients) or not (39 patients). The patients in non-calculus group were divided into three sub-groups: aged 0-1 (eight patients), 1-5 (16 patients), and 5-10 (15 patients). Low dose multislice spiral CT with different doses was performed. Results The rate of positive predictive diagnosis was 100% in both calculus and non-calculus group. Low dose scan reduced the radiation dose of children. The fixed tube current and the decreased tube voltage (decreased 1/3) led to the decrease of the radiation dose (decreased 70%), which were feasible for diagnosis. Conclusion Low-dose multislice spiral CT was available for upper urinary tract obstruction in children.
目的 探討球囊導管擴張術(shù)治療小兒下尿路梗阻的臨床療效。方法 1990年4月～2004年8月，收治下尿路梗阻患兒26例，年齡18 d~12歲，其中后尿道瓣膜23例，前尿道瓣膜2例，外傷性后尿道狹窄1例。術(shù)前常規(guī)行排尿性膀胱尿道造影確診。雙腎均有不同程度的腎盂及輸尿管擴張。術(shù)前伴尿潴留及腎功能不良者行尿液引流及糾正電解質(zhì)紊亂后，再行球囊擴張術(shù)。術(shù)中采用靜脈氯胺酮麻醉，30%泛影葡胺作為球囊擴張劑，應用囊徑分別為5、8和10 mm，囊長4 cm的球囊導管擴張尿道。術(shù)后常規(guī)留置雙腔氣囊導尿管。結(jié)果 23例后尿道瓣膜擴張28次，2例前尿道瓣膜擴張2次，1例后尿道狹窄擴張1次后癥狀好轉(zhuǎn)改用金屬探子擴張治療后3個月治愈，擴張術(shù)中均可見球囊被擠壓痕跡消失。術(shù)后1周拔管，患兒均排尿通暢，尿線增粗。6例術(shù)后1~3個月行膀胱輸尿管防返流術(shù)返流消失。術(shù)后25例獲隨訪1~13年，患兒生長發(fā)育良好，排尿通暢，雙側(cè)腎積水有不同程度的改善。結(jié)論 球囊擴張術(shù)是小兒下尿路梗阻的一種有效的治療方法，且安全簡便。
【摘要】 目的 探討64層螺旋CT尿路造影在上尿路梗阻性病變中的運用及診斷價值?！》椒ā∈占?009年12月—2011年1月132例行螺旋CT尿路造影，并確診為上尿路梗阻病變患者資料，分析其圖像特點并與手術(shù)及病理結(jié)果對比?！〗Y(jié)果 132例患者經(jīng)臨床及手術(shù)病理證實，輸尿管結(jié)石31例，先天異常及畸形51例，輸尿管感染性病變16例，尿路腫瘤29例，外源性壓迫3例，腎盂旁囊腫2例；所有患者均顯示良好，與臨床及病理結(jié)果基本吻合?！〗Y(jié)論 CT尿路造影能多方位清楚顯示病變內(nèi)部及周圍情況，可準確的顯示、判斷尿路梗阻的原因、性質(zhì)，是一種對泌尿系疾病診斷極有價值的影像學檢查方法?！続bstract】 Objective To discuss the utilization and diagnostic value of 64-slice spiral CT urography for upper urinary tract obstruction diseases. Methods We collected the clinical data of 132 patients who were diagnosed with upper urinary tract obstruction by 64-slice spiral CT urography between December 2009 and January 2011. We analyzed the imaging features and compared them with surgical and pathological results. Results Confirmed by surgical and pathological results, 132 patients included 31 cases of urethral stone, 51 cases of congenital variant and malformation, 16 cases of ureteral infection, 29 cases of tumors in urinary tract, 3 cases of extraneous compression, and 2 cases of cysts next to the renal pelvis. CT diagnosis for all cases were basically in line with clinical and pathological results. Conclusion CT urography is an extremely valuable imaging method to diagnose the diseases of urinary system. It can display lesions broadly and reveal their inner and peripheral circumstances clearly, thus can help us determine the reasons and natures of the lesions precisely.