摘要
目的:探讨分次后尿道瓣膜电切术在治疗后尿道瓣膜症中的疗效及优势。方法:收集2016年10月至2020年3月郑州大学第一附属医院小儿外科收治的35例后尿道瓣膜症患儿的资料,其中13例接受单次后尿道瓣膜电切术(单次组),22例接受后尿道瓣膜电切术后1个月再次行后尿道瓣膜电切术(分次组)。手术前后均行泌尿系超声、CT泌尿系成像或磁共振泌尿系水成像、排泄性膀胱尿路造影及肾动态显像等影像学检查,术后6个月复查。比较两组患儿术后肾积水改善率及输尿管反流情况,以及手术前后尿流动力学指标。结果:两组患儿术后肾积水改善率及输尿管反流改善率差异无统计学意义(P>0.05)。术后两组患儿最大逼尿肌压力、最大膀胱容量、膀胱顺应性、自由尿流率及剩余尿量均有明显改善(P<0.05);与单次组比较,分次组术后尿流动力学指标有更大改善(P<0.05)。结论:对于后尿道瓣膜症患儿,分次后尿道瓣膜电切术可以更彻底地切除瓣膜,改善膀胱功能;分次手术的时机以及电切部位的选择是手术取得明显效果的关键。
Aim:To demonstrate the clinical effects and the value of staged urethral valve electrotomy(UVE)in the treatment of posterior urethral valve(PUV).Methods:A total of 35 PUV patients who underwent surgery in the First Affiliated Hospital of Zhengzhou University from October 2016 to March 2020 were analyzed retrospectively.Thirteen children underwent single UVE(single group);twenty-two children accpted staged UVE(staged group),and the interval between the first UVE and the second UVE was one month.Urinary ultrasound,CT urography or magnetic resonance urography,voiding cystourethrography and renal dynamic imaging were performed before and after operation.The postoperative reexamination time was about half a year.The urodynamic indexes of the 2 groups before and after operation were compared.Results:The improvement rates of hydronephrosis and the degree of ureteral reflux in the 2 groups had no significant differences(P>0.05).The urodynamic indexes such as the maximal detrusor pressure,maximum bladder capacity,bladder compliance,uroflowmetry and post voiding residual urine of the 2 groups all improved,and the improvements in the staged group were more significant(P<0.05).Conclusion:For the treatment of children with PUV,step-by-step UVE can remove the valve more thoroughly,and improve bladder function.The timing of the operation and the selection of the site of electrotomy are the key points for the ideal effects of the operation.
作者
王磊
李骥
郭立华
孙权
张谦
WANG Lei;LI Ji;GUO Lihua;SUN Quan;ZHANG Qian(Department of Pediatric Surgery,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)
出处
《郑州大学学报（医学版）》
CAS
北大核心
2022年第4期560-564,共5页
Journal of Zhengzhou University(Medical Sciences)
关键词
后尿道瓣膜症
尿道电切术
尿流动力学
posterior urethral valve
urethral electrotomy
urodynamics
