定时清洁间歇导尿在后尿道瓣膜患儿术后的应用价值  

Application Value of Regular Cleaning and Intermittent Catheterization on Postoperative in Children with Posterior Urethral Valve

作　　者：王磊[1] 李骥[1] 郭立华[1] 孙权[1] 张谦[1] 范应中[1] WANG Lei;LI Ji;GUO Lihua;SUN Quan;ZHANG Qian;FAN Yingzhong(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院小儿外科,河南郑州450000

出　　处：《河南医学研究》2023年第11期1931-1935,共5页Henan Medical Research

摘　　要：目的探讨定时清洁间歇性导尿(STCIC)对于后尿道瓣膜患儿术后输尿管扩张、反流减轻以及膀胱功能改善的作用。方法回顾性分析郑州大学第一附属医院于2019年10月至2021年11月收治的27例后尿道瓣膜症(PUV)患儿,其中12例单纯行后尿道瓣膜电切术(手术组),15例在后尿道瓣膜电切术后6个月内坚持实施STCIC(STCIC组)。对比6个月后两种不同治疗方式对患儿输尿管及膀胱功能的改善有无差异。结果术后与术前比较,手术组与STCIC组最大逼尿肌压力降低,剩余尿量减少,最大膀胱容量、膀胱顺应性、自由尿流率升高,差异有统计学意义(P<0.05);术后,STCIC组膀胱顺应性和自由尿流率高于手术组,剩余尿量低于手术组,差异有统计学意义(P<0.05)。术后,手术组与STCIC组远端输尿管直径比(UDR)比较,差异无统计学意义(P>0.05)。结论STCIC作为后尿道瓣膜电切术后的延续性治疗方式,能够明显改善膀胱功能,但对输尿管功能和结构的恢复作用有限。Objective To investigate the effect of selected time clean intermittent catheterization(STCIC)on ureteral dilatation,reduction of regurgitation and improvement of bladder function in children after posterior urethral valve surgery.Methods A retrospective analysis was performed on 27 children with posterior urethral valve disease admitted to the First Affiliated Hospital of Zhengzhou University from October 2019 to November 2021.Among them,12 cases were treated with posterior urethral valve resection(surgical group),and 15 cases were treated with STCIC within 6 months after transurethral resection of the posterior urethral valve(STCIC group).After 6 months,the improvement of ureteral and bladder function were compared between the two different treatment methods.Results After operation,the maximum detrusor pressure and residual urine volume in the operation group and the STCIC group were significantly lower than those before operation,and the maximum bladder capacity,bladder compliance and free urinary flow rate were significantly higher than those before operation(P<0.05).After the operation,the bladder compliance and free urinary flow rate of the STCIC group were higher than those of the surgery group,and the residual urine volume was lower than that of the surgery group,and the differences were statistically significant(P<0.05).There was no significant difference in distal ureteral diameter ratio(UDR)between the operation group and the STCIC group(P>0.05).Conclusion Regular cleaning and intermittent catheterization as a continuous treatment after posterior urethral valve resection can significantly improve bladder function.However,the recovery of ureteral function and structure is limited.

关 键 词：后尿道瓣膜症 清洁间歇性导尿 尿流动力学 膀胱功能 

分 类 号：R726.9[医药卫生—儿科]