输尿管膀胱扩大成形术治疗神经源性膀胱  

Application of Ureterocystoplasty to treat neurogenic urinary bladder

作　　者：毕允力[1] 阮双岁[1] 陆毅群[1] 王翔[1] 葛琳娟[1] 

机构地区：[1]复旦大学附属儿科医院外科,上海200032

出　　处：《临床小儿外科杂志》2007年第5期21-23,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的介绍我院最近开展的利用输尿管进行膀胱扩大成形术。方法2例均为男性,年龄4岁和12岁,均诊断为神经源性膀胱,其中1例为双侧5级膀胱输尿管返流,采用双侧输尿管下段进行膀胱扩大术;另1例为单侧5级膀胱输尿管返流伴同侧肾无功能,采用单侧输尿管进行膀胱扩大术。结果2例均术后3周拔除膀胱引流管,开始间歇导尿。分别随访2年和6个月,膀胱容量平均增加150%。病例1完全采用间歇性导尿排尿,导尿间隔时间3h,术后逼尿肌不稳定消失,左侧返流消失,右侧返流从5级降至3级;病例2导尿间隔时间4h,偶有经尿道排尿。结论输尿管膀胱扩大成形术是一种治疗神经源性膀胱安全有效的手术方法。Objective To summarize and introduce the new method of bladder augmentation with ureter recently used in our hospital. Methods Two boys, age 4 and 12 years, were diagnosed as neurogenic bladder. Ureterocystoplasty was carried out. One was with grade 5 vesico-ureteral reflux （VUR） of both ureters, the distal segments of both ureters were used for augmentation. The other one was with unilateral grade 5VUR and ipsilateral dysfunctional kidney. One ureter was used for augmentation. Results Both operations were successfully carried out. Bladder drainage was stopped 3 weeks after operation. CIC started immediately. The follow-up periods were 2 years and 6 months. Bladder volume was increased by 150%. Complete intermission catheterization（CIC） in one case, the interval was 3 hours. Detrusor instability disappeared after operation. Left VUR resolved and right side lowered to Grade3. Case 2 used CIC with a 4-hour interval and with occasional urination via urethera. VUR also resolved. Conclusions From the experience of those 2 cases we thought that ureterocystoplasty is technically a safe operation easy to carry out. For patients need bladder augmentation with tourtous ureter, the possible ureterocystoplasty should be considered.

关 键 词：膀胱疾病/外科学 输尿管/外科学 

分 类 号：R726.9[医药卫生—儿科]