摘要
目的总结儿童原发性膀胱输尿管返流(PVUR)的诊断与治疗经验。方法回顾性分析本院近8 a来收治的36例共60侧PVUR患儿的诊治资料,其中1例先行保守治疗,保守治疗无效后行经膀胱内横向黏膜下推进抗返流输尿管膀胱再植术(Cohen手术)治疗,另外35例诊断明确尿路感染控制后均行Cohen手术治疗,术后3～6个月回院复诊,并进行尿常规、排泄性膀胱尿道造影(VCUG)、肾核素扫描等检查,观察治疗效果。结果经VCUG检查证实35例患儿术后返流消失,其中1例患儿术前双侧Ⅳ度返流、慢性肾功能不全,术后VCUG检查膀胱输尿管无返流,但肾功能无改善,并进一步恶化至尿毒症期,透析替代治疗维持生命;1例双侧患病患儿术后7 a复发,再次行Cohen手术治疗,术后6个月复查,效果良好。结论 VCUG检查是诊断PVUR的金标准,Cohen手术治疗儿童PVUR具有创伤小、并发症少、成功率高的优点,是治疗儿童PVUR的经典术式。
Objective To summarize the experience of diagnosis and surgical management of primary vesicoureteral reflux（PVUR） in children. Methods Thirty-six children（60 ureters）,from Aug.2002 to Aug.2010 at the First Hospital Affiliated to Guangxi Medical University,who suffered from severe PVUR,underwent surgical treatment,including 1 case who underwent operation after failed from conservative treatment,the others underwent operation after the control of urinary tract infections.Postoperative follow-up consisted of urinalysis,ultrasonography,voiding cystourethrogram（VCUG） and radioisotope scanning was implemented after 3 to 6 months. Results The procedure was successful in 35 of 36 patients as confirmed by VCUG,1 case of which had chronic renal failure,though the function of his renal did not improve but to get worsed after the operation.One patient recurred after 7 years and had to receive Cohen surgical treatment again and this time it had a good effect. Conclusions VCUG is the gold standard for the diagnosis of PVUR,and Cohen surgical management is the classic treatment for severe PVUR with a high successful rate,minimal trauma and of complication.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2011年第23期1801-1803,共3页
Journal of Applied Clinical Pediatrics
