儿童膀胱尿道异物15例报告并文献复习  

Report of 15 cases of bladder and urethral foreign bodies in children and literature review

作　　者：院恩萌[1] 杨艳芳[1] 毕建朋 李梁斌 樊宏杰 李星[1] YUAN Enmeng;YANG Yanfang;BI Jianpeng;LI Liangbin;FAN Hongjie;LI Xing(Department of Urology,Zhengzhou University Affiliated Children s Hospital,Henan Provincial Children s Hospital Zhengzhou Children s Hospital,Zhengzhou 450018,China)

机构地区：[1]郑州大学附属儿童医院,河南省儿童医院郑州儿童医院泌尿外科,河南郑州450018

出　　处：《现代泌尿外科杂志》2024年第12期1095-1098,共4页Journal of Modern Urology

摘　　要：目的总结并分析儿童膀胱尿道异物的多种治疗方法及经验。方法选取郑州大学附属儿童医院泌尿外科于2015年8月—2024年2月收治的15例膀胱尿道异物患儿作为研究对象,总结并分析其病例特点、临床表现、手术方式、手术技巧及术后恢复情况。结果15例患儿年龄7~13岁,平均(11.0±1.6)岁,其中男性14例,女性1例。术前均由彩色多普勒超声检查及腹部立位平片明确诊断,14例行急诊手术取出异物,1例因合并脓尿经抗感染治疗2 d后行开放手术取出异物。15例患儿中有9例异物直接经膀胱镜取出,2例经膀胱镜检查联合经皮肾穿刺套件取出,2例经膀胱镜检查联合经耻骨上方小切口手术取出,1例经膀胱镜检查联合经阴囊切口取出,1例经膀胱镜检查联合经会阴部切口取出。患儿的手术时间(63.3±50.5)min、术中出血量(1.9±1.9)mL、术后住院时间(5.8±3.8)d。所有患儿均未出现尿外渗、尿瘘、膀胱憩室、排尿障碍等并发症。术后门诊随访1、3个月,15例患儿均无排尿异常、泌尿系感染等并发症发生。结论儿童膀胱尿道异物发病隐匿,一旦确诊,需尽快手术治疗,手术方式需根据异物位置、大小、形态、数目及是否伴有结石形成等综合评估后选择,该疾病大多可经微创手术治疗。Objective To summarize various treatment methods and experiences of bladder and urethral foreign bodies in children.Methods A total of 15 children with bladder and urethral foreign bodies admitted to our hospital during Aug.2015 and Feb.2024 were selected.The characteristics,clinical manifestations,surgical methods,surgical skills and postoperative recovery were analyzed.Results The patients aged 7-13(11.0±1.6)years,including 14 males and 1 female.Preoperative diagnosis was confirmed with color Doppler ultrasound and abdominal standing plain film.Emergency surgery was performed in 14 cases,and open surgery in 1 case with concurrent pyuria,whose foreign bodies were removed after 2 days of anti-infection treatment.Among the 15 children,9 had foreign bodies removed through cystoscopy,2 through cystoscopy combined with percutaneous renal puncture kit,2 through cystoscopy combined with a small incision on the pubic bone,1 through cystoscopy combined with a scrotal incision,and 1 through cystoscopy combined with a perineal incision.The average surgical time was(63.3±50.5)min,blood loss(1.9±1.9)mL,and postoperative hospitalization(5.8±3.8)days.No complications such as urinary extravasation,urinary fistula,bladder diverticulum,or urinary disorders occurred.Postoperative follow-up of 1 and 3 months showed no complications such as abnormal urination or urinary tract infections.Conclusion The onset of bladder and urethra foreign bodies in children is concealed.Once the diagnosis is confirmed,surgery should be performed as soon as possible.The surgical method should be selected based on the comprehensive evaluation of the location,size,shape,and number of foreign bodies and presence of calculi.Minimally invasive surgery can be performed in most cases.

关 键 词：儿童 膀胱 尿道 异物 手术治疗 

分 类 号：R691.4[医药卫生—泌尿科学]