摘要
目的：总结气膀胱输尿管再植术治疗小婴儿输尿管膀胱交界处梗阻的临床经验。方法回顾性分析2006年2月至2013年3月本院收治的19例年龄小于1岁、行气膀胱输尿管再植术的输尿管膀胱交界处梗阻患儿临床资料，并与同期年长儿组32例进行对比。婴儿组单侧12例，双侧7例，22根输尿管行再植，4根行裁剪＋再植；年长儿组单侧25例，双侧7例，30根输尿管行再植，9根行裁剪＋再植。结果所有病例无中转开放手术，无输血。婴儿组手术时间长于年长儿组（P＜0.05），术后泌尿道感染发生率高于年长儿组。年长儿组中1例出现吻合口梗阻急行手术置支撑管，拔管后吻合口引流通畅。共41例患儿获随访，随访率80．4％。B超示输尿管扩张较术前普遍好转；排尿性膀胱尿道造影（VCUG）发现3根输尿管存在低级别反流；除4例术前患肾功能严重受损之外，其余患儿分肾功能维持原有水平或轻度好转。随访情况两组间无明显差别。结论气膀胱输尿管再植术治疗输尿管末端梗阻，在小于1岁的小婴儿病例中手术难度大于年长儿，但通过熟练掌握腹腔镜技术可减少并发症，提高手术安全性，在小婴儿中同样能取得满意疗效。
Objetive To summarize the clinical experience of the pneumovesicoscopy ureteral reimplant-ation operated on infants with vesicoureteral junction obstruction（VUJO）. Methods Clinical data of 1 9 cases which were less than 1 years old and had underwent pneumovesicoscopy ureteral reimplantation on VUJO be-tween 2006-02 and 201 3 -03 in our hospital was reviewed.The data were compared with the elder children group of 32 cases.The infantile group was unilateral in 1 2 cases and bilateral in 7 cases while the elder group was unilateral in 25 cases and bilateral in 7 cases. Results No cases were converted to open operation and no cases need blood transfusion.In infantile group,the operative duration were much longer than it was of the eld-er group （P〈0.05 ）.The complication rate between the 2 groups had no significant difference.41 cases fol-lowed up,most of them have a satisfactory effect. Conclusion Although the operation of infantile group was more difficult,the pneumovesicoscopy ureteral reimplantation can still achieve good results which were similar to the elder children,since skillful laparoscopic technique can reduce the complications and make the operation safe and effective.
出处
《临床小儿外科杂志》
CAS
2014年第4期287-290,共4页
Journal of Clinical Pediatric Surgery
关键词
输尿管梗阻
外科手术
婴儿
Ureteral Obstruction
Surgical Procedures,Operative
Infant
