经尿道电切治疗新生儿后尿道瓣膜症  

Transurethral resection of posterior urethral valves in neonates

作　　者：郭云飞[1] 马耿[1] 葛征[1] 陆如刚[1] 

机构地区：[1]南京医科大学附属南京儿童医院泌尿外科,南京210008

出　　处：《中华腔镜泌尿外科杂志（电子版）》2012年第6期48-50,共3页Chinese Journal of Endourology(Electronic Edition)

摘　　要：目的探讨新生儿后尿道瓣膜症临床特点和经尿道电切治疗效果。方法回顾性分析2003年至2011年间14例新生儿后尿道瓣膜症患儿资料。年龄3～21d，平均14d。产前检查发现肾积水5例，输尿管扩张4例。入院后即刻导尿，纠正水电失衡并控制感染后，采用11F或8F小儿电切镜和钩状电极在12点处切开12例，8F小儿膀胱镜和BUGBEE电极12点切开2例。术后继续导尿3周。结果导尿1～2周后，患儿感染和水电失衡均可控制。本组患儿全部为Young分型I型，瓣膜组织较厚。手术顺利，术后排尿情况改善，肾功能恢复正常。但随访观察发现部分患儿肾积水和膀胱输尿管反流持续存在。结论产前检查的普及使后尿道瓣膜症的确诊时间提前，经尿道电切治疗是新生儿后尿道瓣膜症的最佳选择。术前术后的引流可以减少肾功能损害，且需要长期随访以了解上尿路恢复情况。Objective To evaluate the clinical features of posterior urethral valves （PUV） in neonates and the value of transurethral resection. Methods Forteen neonatal patients with PUV in our hospital from 2003 to 2011 were retrospectively analyzed. Mean age was 14 days, range from 3 to 21 days. Hydronephrosis in 5 cases and hydroureter in 4 cases were found by prenatal examinations. All patients were catheterized soon after admittion. After controlling infection and correcting the fluid and electrolytes imbalance, PUVs were resected at 12 o＇clock positions by 8 F resectoscope in 12 cases, 12 o＇clock positions by cystourethroseopes and Bugbee electrodes in 2 cases. The catheter time were 3 weeks. Results There were no infection and the fluid and electrolytes imbalances were corrected after 1-2 weeks catheterizing. All patients were type [ based Young＇s classification. The valves were thick and operations were successful. The voiding situation improved and renal functions returned to normal postoperatively. But some cases still had hydronephrosis and vesico-ureteric reflux during follow-up. Conclusion The diagnosis time of PUV becomes earlier with the popularity of prenatal examination. Primary transurethral valve resection is the best initial treatment. The division pre-and post-operation can decrease the deterioration of renal function. Long-term follow-up is needed to investigate the upper urinary tract function.

关 键 词：后尿道瓣膜 新生儿 经尿道切除 

分 类 号：R722.1[医药卫生—儿科]