小儿前尿道瓣膜诊治11例  

Clinical analysis of treatment of anterior urethral valves in children

作　　者：张岗[1] 王盛兴[1] 杨增雷[1] 白明[1] 张敬悌[1] 

机构地区：[1]西安市儿童医院泌尿外科,陕西省西安市710002

出　　处：《临床小儿外科杂志》2016年第1期85-87,共3页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨小儿前尿道瓣膜的治疗方法及临床疗效。方法回顾性分析2003年1月至2013年5月作者收治的11例前尿道瓣膜患儿临床资料,患儿均为男性,年龄3个月至8岁,平均2岁8个月,其中年龄1岁以下6例。8例使用7.5F或9F膀胱尿道镜在尿道的4点、6点和8点处切开瓣膜,并留置导尿管10 d。对其中3例合并前尿道憩室的患儿,2例行憩室切除、尿道成形术;1例一期行膀胱造瘘术,二期行憩室切除、尿道成形术。结果 11例均手术顺利,术后均排尿通畅。无尿瘘及尿道海绵体损伤。随访3个月至4年,平均1.5年。尿白细胞消失,阴茎阴囊交界处包块消失。合并肾积水2例,膀胱输尿管反流3例,B超复查均有不同程度缓解。肾功能检查血清尿素、肌酐均正常。结论腔内冷刀切开治疗前尿道瓣膜症是一种可行的方法,疗效确切,术后并发症少,预后好。合并前尿道憩室患儿可选择憩室切除、尿道成形术。Objetive To investigate the treatment and clinical efficacy of anterior urethral valves in chil- dren. Methods 11 cases range from 3 month to 8 year with mean age 32 month with anterior urethral valves in our department were analyzed retrospectively from Jan 2003 to May 2013. Eight of them were cut valves using 7.5F or 9F cystourethroscopy at 4：00,6：00 and 8：00 point of the urethra. And the catheter was to be kept 10 days. Three of them combined anterior urethral diverticulum ,two patients were treated of the operation diver- ticulum resection and urethroplasty, one patient was treated of the operation diverticulum resection and urethro- plasty after the cystostomy. Results All operations were successful. All patients urinated normally without u- rethral fistula and spongiosum injury. FoUow-up of 3 months to 4 years average 1.5 years, leukocytes in urine disappear. The mass was disappearing between penis and scrotum. Tow patients have hydronephrosis and three patients have vesicoureteral reflux. Hydronephrosis and vesicoureteral reflux was relieved than before. Serum u- rea and creatinine were normal. Conclusions Cutting valves using cystourethroscopy is a viable method to treat anterior urethral valves with exact effect fewer complications and good prognosis. Diverticulum resection and urethroplasty is a good choice to the patient who was suffering anterior urethral valves combined anterior u- rethral diverticulum.

关 键 词：尿道/畸形 憩室 外科手术 儿童 

分 类 号：R726.9[医药卫生—儿科]