Clinical and morphological of diagnostics and surgical tactics in the treatment of patients with secondary nephrolithiasis by renal parenchymal dysplasia on the background of renal failure caused in children

F. K. Safedov, A. A. Azizov, Sh. A. Badalov, F. M. Gulomov, I. K. Atoev
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Abstract

The purpose of the study. Improving the results of diagnosis and surgical treatment of patients with secondary nephrolithiasis by renal parenchymal dysplasia on the background of renal failure caused in children.Material and research methods. Clinic of Pediatric Surgery, Avicenna TSMU Abualiibn Sino analyzed 34 patients with renal failure of calculous etiology. In all cases, the biopsy was taken from the cortex – medulla of the kidney during nephrotomy, and during pyelotomy from the site of the nephrostomy tube. Studies of biopsy materials were carried out in laboratorits at the departments of histology, anatomy and oncology.Research results. We analyzed the results of a morphological study of 34 patients with CKD of calculous etiology. Chronic calculous pyelonephritis was detected in 32 (94,1%) patients, in whom the diagnoses coincided with the clinical and morphological ones. Of these, dysplasia of the renal parenchyma was detected in 8 patients. In 2 patients, histological examination did not reveal structural changes, possibly a biopsy was taken from healthy areas of the kidney tissue, although clinically and laboratory 100% calculous pyelonephritis occurred.Conclusion. Thus, in case of obstructive-calculous pyelonephritis, against the background of dysplasia of the kidney parenchyma, early clinical and morphological diagnostics, radical decompressive and sanitation surgery with reliable external urine wood is restored, the process of further wrinkling of the kidney is suspended.
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治疗儿童肾功能衰竭背景下肾实质发育不良引起的继发性肾炎患者的临床和形态诊断及手术策略
研究目的改善儿童肾功能衰竭背景下肾实质发育不良引起的继发性肾结石患者的诊断和手术治疗效果。Avicenna TSMU Abualiibn Sino 小儿外科诊所对 34 名结石性肾衰竭患者进行了分析。在所有病例中,活检都是在肾切开术中从肾皮质-髓质处进行的,在肾盂切开术中从肾造瘘管部位进行的。活检材料的研究在组织学、解剖学和肿瘤学部门的实验室中进行。我们分析了 34 名结石性肾盂肾炎患者的形态学研究结果。32名(94.1%)患者被查出患有慢性结石性肾盂肾炎,其诊断与临床和形态学诊断一致。其中,8 名患者的肾实质发育不良。在 2 名患者中,组织学检查未发现结构性变化,这可能是因为活检取自肾脏组织的健康部位,但临床和实验室检查均显示 100%存在结石性肾盂肾炎。因此,对于梗阻性结石性肾盂肾炎,在肾实质发育不良的背景下,应及早进行临床和形态学诊断、根治性减压和消毒手术,并恢复可靠的外部尿木,中止肾脏进一步皱缩的过程。
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