CAJ | 학술논문

目的分析和讨论以泌尿道扩张和积水为表现的尿崩症的临床特点和诊治,以提高泌尿科、肾脏科和内分泌科相关专科医生对此特殊情况的认识.方法分析和总结以“泌尿道扩张和积水”为主诉、最后确诊为尿崩症、经对症导尿和抗利尿治疗后缓解的患者3例；复习和汇总1994年后类似病例报道共78例,分析讨论其临床特点、临床诊治注意事项、讨论可能机制及预后相关因素.结果尿崩症继发泌尿道扩张和积水多见于男性(男∶女为2.3∶1)、起病年龄早(＜10岁者占94.9％)、未诊治病程长、可见于中枢性或肾性尿崩症;尿流动力学检测显示非梗阻性泌尿系扩张和积水、最大尿流率并无降低.结论抗利尿治疗,联合早期短时导尿消除残余尿可有效改善尿崩症所致的泌尿道扩张和积水.
목적 분석화토론이비뇨도확장화적수위표현적뇨붕증적림상특점화진치,이제고비뇨과、신장과화내분비과상관전과의생대차특수정황적인식.방법 분석화총결이“비뇨도확장화적수”위주소、최후학진위뇨붕증、경대증도뇨화항이뇨치료후완해적환자3례；복습화회총1994년후유사병례보도공78례,분석토론기림상특점、림상진치주의사항、토론가능궤제급예후상관인소.결과 뇨붕증계발비뇨도확장화적수다견우남성(남∶녀위2.3∶1)、기병년령조(＜10세자점94.9％)、미진치병정장、가견우중추성혹신성뇨붕증;뇨류동역학검측현시비경조성비뇨계확장화적수、최대뇨류솔병무강저.결론 항이뇨치료,연합조기단시도뇨소제잔여뇨가유효개선뇨붕증소치적비뇨도확장화적수.
Objective To analyze the clinical characteristics of the patients with diabetes insipidus who presented with dilatation and hydronephrosis of urinary tract.Methods Three cases with diabetes insipidus who presented with dilatation and hydronephrosis of urinary tract were reported.78 similar case-reports published since 1994 were reviewed,and the possible mechanisms and the prognosis-related factors were discussed.Results The onset-age in most patients was younger than 10,while the disease course prior to the diagnosis was longer than 10 years.There were hypothalamic and nephrogenic diabetes insipidus.The urodynamic examination showed the features of non-obstructive distention and hydronephrosis of urinary tract with normal maximum flow rate in most patients.Conclusion The medication for diabetes insipidus and reducing the residual volume by urethral catheterization for a short term are effective for most patients with this condition.