儿童先天性脊柱侧凸合并泌尿系畸形临床分析

摘要

Objective To explore the occurrence of urological deformities in children with congenital scoliosis and summarize the disease features. Methods From December 2005 to June 201 6,a total of 75 children of congenital scoliosis with urological deformities were recruited. There were 40 males and 35 females with a mean diagnostic age of 53 months. Results The causes were renal deformity (n=50),cryptorchism (n=8),hapospadia (n=9)and others (n=1 0). All patients underwent spinal surgery alone. Conclusions Urological deformity is frequently present in congenital scoliosis patients. Careful examination,ultrasound and CT scan may aid an early diagnosis.%目的：了解儿童先天性脊柱侧凸合并泌尿系畸形的发生情况，分析并总结其临床特点。方法回顾性分析本院2005年12月至2016年6月收治的75例第一诊断为先天性脊柱侧凸患儿的临床资料，其中男性40例，女性35例，平均首诊年龄4岁5个月。结果75例患儿中，先天性脊柱侧凸合并肾脏畸形50例（孤立肾22例，异位肾9例，马蹄肾7例，重肾8例，异位融合3例，分支状肾盂1例），隐睾8例，尿道下裂9例，其他泌尿系异常10例（4例泌尿系结石，1例双侧输尿管囊肿，2例双肾积水，1例神经源性膀胱，1例脐尿管囊肿，1例遗尿）。首次住院前仅4例完成尿道下裂修复手术，1例接受输尿管切开取石手术。所有病例行脊柱矫形手术时均未对泌尿系畸形进行手术干预。本组病例脊柱侧凸矫正顺利，效果满意。脊柱矫形术后随访3个月至10年1个月，平均6年3个月。结论先天性脊柱侧凸合并泌尿系畸形较常见，细致的体格检查、腹部B超，结合脊柱CT筛查能尽早发现，针对性随访及处理泌尿系畸形，改善患儿远期预后。