后尿道瓣膜症瓣膜切开前后膀胱功能的变化研究  

Changes of Bladder Function in Children with Posterior Urethral Valve Before and after Valves Ablation

作　　者：莫志强 谢向辉[2] 高志学 孙宁[2] 张潍平[2] 田军[2] 李明磊[2] 宋宏程[2] 王文杰[2] Mo Zhiqiang;Xie Xianghui;Gao Zhixue(Shunyi Women′s and Children′s Hospital of Beijing Children′s Hospital,Beijing 101300,China)

机构地区：[1]北京市顺义区妇幼保健院、北京儿童医院顺义妇儿医院,101300 [2]首都医科大学附属北京儿童医院、国家儿童医学中心

出　　处：《医学研究杂志》2020年第5期80-82,87,共4页Journal of Medical Research

基　　金：国家重点研发计划项目(2016YFC1000807);北京市医院管理局扬帆计划项目(ZYLX201709);北京儿童医院顺义妇儿医院妇幼健康基金资助项目(YFYJK-201709)。

摘　　要：目的了解手术改善后尿道瓣膜症患儿膀胱功能的效果和手术前后膀胱功能的变化。方法回顾性分析2014年1月~2016年12月在北京儿童医院及北京儿童医院顺义妇儿医院住院治疗并完成了手术前、后尿流动力学检查后尿道瓣膜症患者的临床资料。共7例患者,首诊年龄5个月~9岁2个月,平均年龄为4岁7个月,手术年龄5个月~9岁2个月,平均手术年龄4岁7个月。结果7例患儿诊断为后尿道瓣膜症,随访时间3~96个月,平均随访时间32.7个月。术后复查尿流动力学时间为距术后3~21个月,平均6.9个月。手术前、后尿流动力学检查结果显示,最大膀胱测量容积138.86±116.13ml vs 174.71±100.20ml;残余尿量82.29±90.22ml vs 57.71±75.03ml;膀胱顺应性9.54±14.05ml/cmH 2O vs 16.23±12.62ml/cmH 2O;最大尿流率5.57±3.84ml/s vs 13.27±10.22ml/s。本组患儿最大膀胱容积、残余尿量、膀胱顺应性、最大尿流率在手术前、后两组数值变化比较,差异无统计学意义(P>0.05)。结论尿流动力学检查是监测后尿道瓣膜症病情变化的有效手段,瓣膜切开对改善最大膀胱容积、膀胱顺应性、残余尿量、最大尿流率并不理想。Objective To investigate the Changes of bladder function in children with posterior urethral valve before and after valves ablation.Methods The clinical data and examination data of patients with urethral valve were recieved urodynamic examination before and after valves ablation.They were analyzed retrospectively in our hospital from January 2014 to December 2016,and the changes of bladder function before and after valves ablation were understood.A total of 7 patients were male.The age of first diagnosis was from 5 months to 9 years and 2 months,with an average of 4 years and 7 months.The operation age was from 5 months to 9 years and 2 months,with an average of 4 years and 7 months.Results Seven cases were diagnosed as posterior urethral valve after operation.The postoperative follow-up was 3 months to 96 months,with an average of 32.7 months.The symptoms of urinary system improved significantly after operation.The time of postoperative urodynamic examination ranged from 3 months to 21 months after operation,with an average of 6.9 months.The results of urodynamic examination were:the maximum volume of urinary bladder was 138.86±116.13ml vs 174.71±100.20ml,the residual urine volume was 82.29±90.22ml vs 57.71±75.03ml,and the compliance 9.54±14.05ml/cmH 2O vs 16.23±12.62ml/cmH 2O,and the maximum urine flow rate of 5.57±3.84ml/s vs 13.27±10.22ml/s.The SPSS 20.0 paired t-test showed that the maximum bladder volume,residual urine volume,bladder compliance,and maximum urinary flow rate were not statistically significant between the two groups before and after the operation(P>0.05).Conclusion Urodynamic examination is an effective way to monitor the changes of posterior urethral valve disease.The operation of the valve is not ideal for the improvement of the maximum bladder volume,bladder compliance,residual urine volume and maximum urinary flow rate.

关 键 词：后尿道瓣膜症 膀胱功能 尿流动力学 瓣膜切开术 

分 类 号：R699.5[医药卫生—泌尿科学]