( A ) treatment goal for the cause of eliminating remove the obstruction , based on the improvement of renal function, relieve symptoms, elimination of infection, as far as possible to repair its normal anatomic structures.
(B ) estimates of treatment :
① Age: infants and young children should be treated as soon as possible , young adults may be appropriate to observe , if progress is timely surgery, 50 to 60 years of age or earlier should consider surgery to preserve the integrity of renal function.
② obstruction on renal function and estimates :. A normal kidney tissue to retain at least 1/5 of the minimum life-sustaining functions, such as non-essential , try not to make the kidney drainage, to prevent infection generation. b. asymptomatic patients without infection hydronephrosis , may every 6 to 12 months with B ultrasound, CT and intravenous urography review observed , if no progress can be temporarily surgery. c. ureteropelvic junction obstruction may cause stones, so in addition to simultaneously take calculus must probe whether the cause of stone formation exists. If narrow , should also be corrected.
③ of kidney and renal pelvis surgery estimate : more difficult to deal with the renal pelvis .
Timing of surgery ④ bilateral hydrocephalus : When bilateral hydronephrosis without infection , may deal with poorly functioning side , so continuing in the contralateral compensatory hypertrophy function under load . On the side of plastic surgery under certain stimuli kidneys recover better. For those associated with infection , the serious side of the first should choose surgery as soon as possible and should be the opposite . Function better if only one side of the infection , surgery should be a priority in order to maximize the retention of renal function , infection control , and the other side in a stable condition before considering surgery.
On the side of good kidney function hydronephrosis , but still strive to restore kidney function can plastic surgery , surgery should be considered first . If no contralateral kidney function has been damaged , it must be operated side kidney function to be restored before they decide whether that line stable condition after amputation .
( C) the treatment by:
A local treatment : obstruction lesions available for local processing solvers , such as adhesion separation, fibrous band cut vascular anastomosis shift , stone removal and so on. For too long has caused local compression locally developed severely damaged ureter , ureteral resection and anastomosis should this paragraph .
2 For kidney obstruction has caused serious water , the need to first make ostomy drainage.
3 plastic surgery : plastic surgery must grasp the main points :
① the renal pelvis and ureter anastomosis at the lowest point of the renal pelvis .
② ureteropelvic anastomosis should constitute a funnel .
③ excision repair should be around the fibers , adhesions, scar tissue, but not to damage the blood supply .
④ removal of excess pelvis wall , pelvis to maintain a certain tension . If hydronephrosis is too large, fixed rear turn can be folded within the renal cortex of the thinner to reduce renal volume .
⑤ To reduce anastomotic leak , can be set to double pigtail catheter . To avoid stagnation of urine leakage and hemolysis formed around the stoma scar fibrosis, can be placed in adequate drainage suction tube anastomosis estuary .
⑥ plastic surgery many ways , but from the perspective of the opinion that the cause of the disease pathology resection and anastomosis better.
3 . Medicine treatment
Hydronephrosis caused by back pain belongs to the category of traditional Chinese medicine , the main symptom is pain in the waist . When TCM clinical treatment of hydronephrosis , usually using a dialectical theory for treatment of hydronephrosis . Chinese medicine treatment :陈天伦the compatibility of Gallus gallus gold RONGSHI party , Plantago, frog grass, Alisma, winged shield rattan and other natural herbs Miao made their medication unique combination of valuable medicinal and magical medicine available Miao prescription drug water torture , drugs active ingredients nicely into the soup liquid inside , for oral administration , making the body better able to absorb , thus completely cure kidney stones and kidney stones with hydronephrosis pain.
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