儿童复杂性尿道狭窄的治疗  

The treatment of urethral stricture in children

作　　者：徐月敏[1] 撒应龙[1] 陈忠[1] 乔勇[1] 徐佑璋[1] 金三宝[1] 

机构地区：[1]上海交通大学附属第六医院泌尿外科,200233

出　　处：《中华小儿外科杂志》2002年第6期493-495,共3页Chinese Journal of Pediatric Surgery

摘　　要：目的　探讨儿童复杂性尿道狭窄手术方法的选择及成功的关键。方法　 2 5例复杂性尿道狭窄采用不同的手术方法治疗 30次 ,其中采用口腔粘膜管状重建尿道 3例 ,口腔粘膜补片尿道成形 3例 ;经耻骨径路尿道端端吻合 11例 ,膀胱壁瓣尿道成形 2例 ;经会阴径路尿道端端吻合 8例 ;双阴唇带蒂皮瓣Ⅰ期尿道成形 2例 ;带蒂包皮内板Ⅰ期尿道成形 1例。结果　术后随访 2～ 36个月 ,平均 18.5个月。一次手术后排尿通畅 2 0例 ,术后效果不佳 5例 ,经再次手术后排尿通畅 4例。结论　儿童尿道狭窄手术方法的选择应根据尿道狭窄段的长短、位置选择合适的术式 ;口腔粘膜具有取材方便 ,创伤小 ,有较强的抗感染力的优点 。Objective To evaluate the choice of operative procedures for the urethral stricture in children. Methods Twenty five patients with complicated urethral strictures underwent 30 different procedures. Of them buccal mucosa urethral reconstruction was performed on 6, trans pubic urethral reconstruction on 13, trans perineal urethral reconstruction on 8, one stage urethroplasty utilizing 2 pedicled flaps 2 and preputial island flap urethroplasty 1. Results The patients were followed up for 2 to 36 months (mean 18.5 months). Twenty patients passed urine well after first operation and 5 children had difficulties. Four of them improved after the second operation. Conclusions The choice of procedures for urethral strictures in children depends on length, location and severity of the stricture. Buccal mucosa is easy to obtain with little trauma to the patient and is highly resistant to infection. It is a good material for urethral substitution.

关 键 词：复杂性尿道狭窄 儿童 手术治疗 手术方法 尿道成形术 

分 类 号：R726.9[医药卫生—儿科]