排序方式: 共有3条查询结果,搜索用时 93 毫秒
1
1.
Ureteral stenosis is a comparatively rare complication following hematopoietic stem cell transplantation (HSCT). The etiology is still unclear and most believe that this may be due to the reactivation of BK virus in a state of immunodeficiency. In the later stages of ureteral stenosis with scarring, invasive interventions must be taken to relieve the hydronephrosis. Common treatments, such as D-J stent placement and permanent nephrostomy may not only entail the risk of infection, but also seriously affect the quality of life. Few cases of surgical intervention have been reported. In this article, a 25-year-old female was admitted to Peking University First Hospital suffering from recurrent flank pain. Seven years before, she developed hemorrhagic cystitis and bilateral urethritis 40 days after allogeneic HSCT. After continuous bladder irrigation and antiviral therapy, the left-sided hydronephrosis gradually alleviated while the right-sided one did not improve. D-J stents were used for urine drainage for 7 years before percuta-neous nephrostomy. Preoperative antegrade pyelography revealed significant hydronephrosis in the right kidney with long stricture of proximal-middle ureter. After comprehensive decision, she underwent ileal ureter replacement. The operation was successful. The segmental lesion was dissected and the scar tissue was removed. A 25 cm intestinal tube was isolated to connect the pelvis and bladder. An anti-reflux nipple was created at the distal end of ileal ureter to prevent the potential infection. The blood loss was minimal. After surgery, the drainage tube was removed in 2 weeks, the nephrostomy tube and the D-J stent was removed in 3 months. Follow-up mainly included clinical assessment, serologic testing, renal ultrasonography, blood gas analysis and radiological examination. During the follow-up of 6 years, she was symptom-free and no postoperative complications occurred. The serum creatinine level was stable. No hydronephrosis was observed under ultrasonography. Obvious peristaltic waves and ureteral jets of the ileal ureter was confirmed on cine magnetic resonance urography. To sum up, ureteral stenosis after HSCT is relatively rare. Obstruction caused by scarring is usually irreversible and surgical intervention should be designed according to the location and length of the lesion. Ileal ureter replacement can be a safe, feasible and effective method to solve this kind of complex stricture. 相似文献
2.
3.
目的描述上尿路梗阻回肠代输尿管患者术后的症状和生活质量水平,并分析二者的相关性。方法采用一般资料调查表、自设上尿路梗阻回肠代输尿管手术相关症状量表、健康调查简表对北京市某三级甲等医院回肠代输尿管数据库中95例患者进行问卷调查。结果患者总体症状得分为0~1.44分(中位数为0.23分),生活质量各领域得分最高的是生理机能领域(84.78±16.18)分,最低为生理职能领域(57.89±43.49)分。症状总体与生活质量各领域均呈负相关(r=-0.297~-0.559,P<0.01)。结论上尿路梗阻回肠代输尿管患者术后存在多种症状,以排尿、肾积水、精力症状为主,且症状越重,其生活质量越差。因此,改善症状有助于提高患者的生活质量。 相似文献
1