带血管蒂股前外侧肌肌皮瓣修复青少年膀胱外翻腹壁缺损  

The treatment of application of pedicled myocutaneous island flap of anterolateral thigh muscle for the suprapubic defect in adolescent with bladder exstrophy

作　　者：郭立华[1] 张谦[1] 王磊[1] 李骥[1] 闫跃强 杨宁宁[1] 刘宁[1] 范应中[1] 王家祥[1] Guo Lihua;Zhang Qian;Wang Lei;Li Ji;Yah Yueqiang;Yang Ningning;Liu Ning;Fan Yingzhong;Wang Jiaxiang(Department of Pediatric Surgery,First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院小儿外科,450052

出　　处：《中华整形外科杂志》2018年第12期1023-1026,共4页Chinese Journal of Plastic Surgery

摘　　要：目的探讨应用带血管蒂的股前外侧肌肌皮瓣修复膀胱外翻患儿腹壁缺损的治疗效果。方法分析2011年1月至2017年1月收治的3例大龄女性膀胱外翻患儿的临床资料。3例患儿均行Kelly手术一期修复膀胱外翻,并同期应用带血管蒂股前外侧肌肌皮瓣修复腹壁缺损,Kelly一期手术包括膀胱内翻缝合、后尿道延长、尿道成形、膀胱颈重建及会阴成形。1例患儿于一期术后半年行回肠浆肌层补片膀胱扩大术及Cohen输尿管膀胱再植术,余2例患儿未行二期手术。结果3例患儿手术均顺利完成,股部供区均直接缝合,未行游离植皮修补。术后随访1~7年,转移肌皮瓣存活,切口愈合良好,股部供区切口均一期愈合,无瘢痕增生。2例患儿基本控尿,1例患儿部分控尿,均无反复泌尿系感染、发热及腹痛等症状。结论采用转移股外侧肌肌皮瓣修复膀胱外翻患儿耻骨上腹壁缺损,术后效果较好。Objective To explore the treatment effect of pedicled myocutaneous island flap of anterolateral thigh muscle on the suprapubic defect caused by bladder exstrophy in children.Methods The clinical data of 3 adolescents with bladder exstrophy were analyzed.All 3 cases underwent one-stage Kelly procedure and received the treatment using pedicled myocutaneous island flap of anterolateral thigh muscle to repair the suprapubic defect.The bladder expansion was performed with ileal sarcoplasmic layer graft,and the Cohen ureteral reimplantation was performed as well,for 1 case 1,1 year after the first operation.The others 2 patients didn't receive the second operation.Results All operations were successful.The femoral donor regions were directly closed.Postoperative follow-up period was 1-7 years. The myocutaneous island flaps were survived and grew well.All incisions of the femoral donor region were primary healing without scar hypertrophy.Urinary continence was achieved in 2 cases,and partially achieved in 1 case.Recurrent urinary tract infection,recurrent fever or abdominal pain were not observed in all patients.Conclusions The pedicled anterolateral thigh myocutaneous island flap is an alternative way to repair suprapubic defect caused by bladder exstrophy.

关 键 词：膀胱外翻 青少年期 手术治疗 

分 类 号：R726.5[医药卫生—儿科]