收稿日期：2023-02-08 接受日期：2023-02-08 出版日期：2023-02-08 发布日期：2023-02-08
通讯作者： 周辉霞,主任医师,教授,儿科医学部小儿外科主任医师,中国人民解放军总医院第七医学中心儿科医学部 泌尿外科，北京 10007；
作者简介： 周辉霞,女,中国人民解放军总医院第七医学中心儿科医学部 泌尿外科，北京 10007；,主任医师,教授,擅长小儿外科微创手术技术研发，小儿泌尿系疾病的诊断和治疗，小儿泌尿系统高难度重建性手术的微创治疗。担任中华医学会泌尿外科学分会小儿学组组长、中国医师协会结构畸形外科专业委员会主任委员。 . 贾红帅,中国人民解放军总医院研究生院，北京 . 张巍,南方医科大学第二临床医学院 泌尿外科，广州 510280 . 李品,中国人民解放军总医院第七医学中心儿科医学部 泌尿外科，北京 .
基金资助：军队计生专项（18JS001），项目负责人： 周辉霞
中图分类号：R726.9
文献标识码：A
文章编号：1674-7410(2022)02-0001-05
DOI：10.20020/j.CNKI.1674-7410.2022.02.01
关键词： 欧洲泌尿外科学会指南, 肾盂输尿管连接部, 输尿管膀胱连接处, 后尿道瓣膜, 肾积水,
图 1 小儿上尿路扩张疾病诊断评价流程图 注：VCUG：排泄性膀胱尿道造影。
表1 EAU 指南中 UPJ 和 UVJ 梗阻的证据和级别
表2 EAU 指南中 UPJ 和 UVJ 梗阻的指南推荐及等级
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[1]周辉霞,贾红帅,张巍,李品.2022版欧洲泌尿外科学会小儿泌尿诊疗指南更新解读——UPJ与UVJ梗阻、后尿道瓣膜专题[J].泌尿外科杂志(电子版),2022,14(02):1-5+9.DOI:10.20020/j.CNKI.1674-7410.2022.02.01.
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后尿道瓣膜是新生儿期发现的少数危及生命的先天性尿路异常之一，近三分之一的病例出现肾功能不全。双侧输尿管肾积水和膀胱增大是新生儿 PUV 的可疑征象。VCUG 是 PUV 的诊断的金标准。肾动态显像可用于肾功能的评估。发现获益人群是产前治疗的关键。
产后治疗包括膀胱引流、经尿道或耻骨上引流，如果患儿病情允许，需在内镜下切开瓣膜。如果膀胱引流不足以引流上尿路尿液，应考虑行肾造瘘引流。
因为合并膀胱功能障碍，必须对 PUV 患者施行终身随访。10%~47%的患者可能发展为终末期肾功能衰竭，这些患者可进行肾移植。
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