双侧前外侧骨盆截骨治疗小儿膀胱外翻  

Bilateral anterior lilac osteotomies in bladder exstrophy repair

作　　者：徐卯升[1] 刘国华[2] 耿红全[1] 徐国锋[1] 谢华[3] 陈方[3] 

机构地区：[1]上海交通大学医学院附属新华医院小儿外科,200092 [2]上海第一人民医院泌尿外科 [3]上海交通大学附属上海儿童医院泌尿外科

出　　处：《中华小儿外科杂志》2010年第4期262-264,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的评价双侧前外侧骨盆截骨在治疗小儿膀胱外翻中的应用。方法1997年1月至2007年12月13例膀胱外翻患儿在本院行双侧前外侧骨盆截骨术合拢骨盆环，膀胱内翻关闭术，年龄6个月～13岁。其中3例是曾在外院作过膀胱外翻关闭手术失败的病例。骨盆截骨采用从髂前上棘髂前下棘之间到坐骨大切迹的前外截面。结果平均随访5年（6个月～10年）。I期修复膀胱外翻，术后无腹壁伤口裂开，耻骨合拢处分离不超过2cm，步态正常。其中3例男性患儿术后随访排尿得到了良好控制。结论双侧前外侧骨盆截骨在术中不需要改变体位，截骨后使耻骨尽可能合拢，且可用于膀胱外翻关闭手术失败再次截骨，较传统的后侧骨盆截骨术治疗膀胱外翻更优越。骨盆截骨手术有助于膀胱外翻患儿今后控制排尿。Objective To evaluate the efficacy of bilateral anterior iliac osteotomies to repair bladder exstrophy in children. Methods From January 1997 to December 2007, 13 children with bladder exstrophb,, aged from 6 months to 13 years, underwent bilateral anterior iliac osteotomies at this center. Three patients had the history of failed initial surgery. Osteotomy was made on anterior external surface from the anterior superior iliac spine and the anterior inferior iliac spine to the greater sciatic notch. Results The 13 patients were followed up for a mean period of 5 years （range： 6 months to 10 years）. No dehiseence was noted in the osteotomy group. All patients were achieved symphyseal approximation of less than 2 cm. Their locomotion was normal. Three boys obtained urinary continence. Conclusions The procedure of anterior iliac osteotomies has some advantages over the traditional posterior lilac osteotomies in treatment of bladder exstrophy. By this treatment, patients achieve better clinical outcomes.

关 键 词：膀胱外翻 截骨术 泌尿外科手术 

分 类 号：R726[医药卫生—儿科]