黑色亲水导丝引导下经皮肾扩张器在尿道下裂术后尿道狭窄患儿中的临床应用  

Clinical application of percutaneous renal expander guided by black hydrophilic wire in children with urethral stricture after hypospadias

作　　者：胡建军 赵夭望[1] 刘宇[1] 祖建成[1] 陈毅夫[1] Hu Jianjun;Zhao Yaowang;Liu Yu;Zu Jiancheng;Chen Yifu(Department of Urology,Hunan Children's Hospital,Changsha 410007,China)

机构地区：[1]湖南省儿童医院泌尿外科,长沙410007

出　　处：《国际泌尿系统杂志》2023年第5期849-852,共4页International Journal of Urology and Nephrology

基　　金：湖南省卫生健康委课题(202204052510);湖南省儿童泌尿生殖疾病临床医学研究中心(2021SK4017)。

摘　　要：目的探讨黑色亲水导丝引导下经皮肾扩张器在尿道下裂术后尿道狭窄患儿中的临床应用。方法回顾性分析2019年1月至2021年1月本院收治的33例尿道下裂术后尿道狭窄患儿的临床资料,其中19例行经黑色亲水导丝引导下经皮肾扩张器扩张狭窄段尿道,14例行经传统金属尿道扩张器扩张狭窄段尿道,术后检测尿流率,并随访3个月。结果19例经黑色亲水导丝引导下行经皮肾扩张器扩张狭窄段尿道的患者均扩张成功,无明显出血、穿孔、假道形成并发症发生,随访3个月内无尿道瘘、尿道狭窄复发,患儿排尿通畅,尿流率正常。14例经传统金属尿道扩张器扩张狭窄段尿道的患者中9例扩张成功,3例失败,5例出现红肿、出血、假道等并发症。两种方式扩张成功患儿随访3个月内无尿道瘘、尿道狭窄复发,患儿排尿通畅,尿流率正常。两种扩张方式的患儿术后最大尿流率、并发症发生率比较,差异均有统计学意义(均P<0.05),而平均尿流率、失败例次比较,差异均无统计学意义(均P>0.05)。结论黑色亲水导丝引导下经皮肾扩张器扩张尿道下裂术后尿道狭窄患儿安全、可靠,值得临床推广。Objective To investigate the clinical application of percutaneous renal expander guided by black hydrophilic guide wire in children with urethral stricture after hypospadias.Methods A retrospective analysis was performed on 33 children with urethral stricture after hypospadias treated in our hospital from January 2019 to January 2021.Among them,19 patients underwent percutaneous urethral dilatation with black hydrophilic guide wire,and 14 patients underwent traditional metal urethral dilatation with urethral stricture dilatation.Urine flow rate was detected after surgery,and the patients were followed up for 3 months.ResultsAll of the 19 patients who underwent percutaneous renal dilator to dilate urethra in the narrow segment under the guidance of black hydrophilic guide wire were successfully dilated,and no obvious bleeding,perforation,or complications of pseudocanal formation occurred.No urethral fistula or urethral stenosis recurred within 3 months of follow-up.The children were unobtrusive in urination,and the urine flow rate was normal.Among the 14 patients who underwent traditional metal urethral dilator to dilate the narrow urethra,9 cases were successful,3 cases were unsuccessful,and 5 cases had complications such as redness,swelling,bleeding and false track.No urethral fistula or urethral stricture recurred in the patients with successful dilation by the two methods within 3 months of follow-up.The patients had unobstructed urination and normal urine flow rate.There were statistically significant differences in the maximum urinary flow rate and complication rate of the children with the two dilation methods(all P<0.05),but there were no statistically significant differences in the average urinary flow rate and failure cases(all P>0.05).Conclusions Percutaneous renal expander guided by black hydrophilic guide wire is safe and reliable for urethral stricture in children with hypospadias.

关 键 词：尿道下裂 尿道狭窄 扩张器 导丝 

分 类 号：R726.9[医药卫生—儿科]