Timing Of Operation For Children Hydronephrosis Caused By UPJO And Study On The Application Value Of Three Renal Tubules

Objective: To explore the timing of operation and the application value of three renal tubules in children with hydronephrosis caused by UPJO.Methods:The clinical data of 50 children who underwent left or right ureteropelvic plasty for congenital narrowing of the junction of renal pelvis and ureter from January 2018 to December 2020 were analyzed retrospectively.According to the age of operation,they were divided into two groups:group A,in which 25 children were operated within 12 months,and group B,in which 25 children were operated after 12 months.All 50 children were measured and analyzed by urinary B-ultrasound in our hospital before operation,urine N-acetylβD glucosaminidase(NAG),urineα1-MG microglobulin(α1-MG),urineβ2-MG microglobulin(β2-MG),renal function(DRF)and renal artery imaging(SPECT)before and after operation.At the same time,the changes of children before and after operation were compared by SFU and Grigono grading,and they were followed up regularly after operation.Results: There was no significant difference in β2-mg,renal parenchyma thickness,α1-mg,APD,NAG and DRF between group A and group B before operation(P(29)0.05).There was statistical significance in comparing the above indexes between group A and group B after operation(P(27)0.05).Comparing the above indexes before and after operation in group A and group B,the difference was statistically significant(P(27)0.05).According to SFU classification before and after operation,there were 9 cases in Grade 3 and 16 cases in Grade 4 in Group A,and 11 cases in Grade 3 and 14 cases in Group B,and there was no difference between the two groups.However,the postoperative recovery in Group A was mostly in Grade 0,accounting for about 68%,and in Group B,most of them were concentrated in Grade 1,accounting for about 52%,which showed that the overall recovery in Group A was betterl.The other two groups were compared before and after operation according to Grigono grading standard: 7 cases in group A were grade Ⅳ and 18 cases in group B were grade Ⅳ and 16 cases in group Ⅴ,and there was no difference between the two groups before operation,while the postoperative recovery of group A was about 92%,and that of group B was about 64%,which also proved that the overall recovery of group A was better than that of group B.Conclusion: Early operation should be performed for children with congenital hydronephrosis caused by unilateral UPJO,which can improve the recovery of renal morphology and function as soon as possible.Three items of renal tubules are important indexes to judge renal function damage before operation and to follow up renal function recovery after operation in children with congenital hydronephrosis.