Correlation Analysis Of Postoperative Curative Effect And Degree Of Hydronephrosis In Children With Ureteropelvic Junction Obstruction

Objective: By analyzing 200 children with congenital obstruction of the ureteropelvic junction in Pediatric Surgery of Qilu hospital,they were grouped according to the degree of hydronephrosis to explore the relationship between the degree of hydronephrosis and each index to standardize clinical practice.Method:From August 2017 to August 2020,children with congenital obstructive hydronephrosis at the junction of the pelvis and ureter were admitted to the Department of Pediatric Surgery Qilu Hospital,and 200 cases of laparoscopic disconnected pyeloplasty were selected.According to the degree of hydronephrosis before surgery: Mild: The appearance of the kidney and the thickness of the renal parenchyma are normal,the anterior and posterior diameter of the renal pelvis is separated by less than 1.5cm;Moderate: The appearance of the kidney increases,the renal parenchyma becomes thinner,the renal pelvis and calyces are dilated,and the anterior and posterior diameter of the renal pelvis is 1.5-2.0cm;Severerthe volume of the kidney is obviously increased,the renal parenchyma is thinned or completely atrophy,and the anterior and posterior diameter of the renal pelvis is more than 2cm.There were 19 children with mild hydronephrosis,66 children with moderate hydronephrosis,and 115 children with severe hydronephrosis.The relationship between the degree of hydronephrosis and each index were explored to standardize clinical practice.Result:The APD and PT values of diseased kidney in children with moderate and severe hydronephrosis after operation were significantly improved compared with those before operation(P <0.05),but in children with mild hydronephrosis the difference was not statistically significant(P>0.05).The Spearman correlation analysis showed that operation time was significantly correlated with preoperative hydronephrosis(r = 0.624),postoperative hospital day was significantly positively correlated with the degree of preoperative hydronephrosis(r = 0.485),the time to remove the abdominal drainage tube was significantly positively correlated with the degree of preoperative hydronephrosis(r =0.559),the time to remove the Urinary tube is significantly positively correlated with the degree of hydronephrosis before surgery(r = 0.418).postoperative PD value is significantly positively correlated with the degree of hydronephrosis before surgery(r =0.487).postoperative APT value is significantly negatively correlated with the degree of hydronephrosis before surgery(r =-0.072).but there was not statistical significance.postoperative complications is significantly positively correlated with the degree of hydronephrosis before surgery(r = 0.060).but there was not statistical significance.Conclusion:1.Anderson-Hynes disconnected pyeloplasty has a clear effect on children with ureteropelvic junction obstruction.2.After the obstruction is relieved by surgery,the childrenJ s APD value and PT value can be improved.The time to remove the abdominal drainage tube,the time to remove the Urinary tube,hospital stay,and operation time are all related to the degree of preoperative hydronephrosis.Therefore,for children with moderate to severe hydronephrosis,the earlier the operation,the smaller the surgical trauma,and the faster the postoperative recovery.3.For children with mild hydronephrosis,clinicians should strictly grasp the surgical indications and strengthen follow-up.Symptomatic childrenwith congenital obstruction of the ureteropelvic junction are actively recoxnmened surgical intervention.