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目的:探讨输尿管镜下膀胱颈电切术治疗小儿先天性膀胱颈梗阻的临床价值。方法:回顾性分析2008年6月至2011年12月广州医学院第一附属医院泌尿外科收治的6例行输尿管镜下膀胱颈电切术的小儿先天性膀胱颈梗阻患者的临床资料。6例患儿均为男性,平均年龄6.5岁,主要表现为排尿困难、膀胱输尿管返流和膀胱颈后唇抬高。在8.0/9.8F输尿管硬镜直视下用电切杆在5点及7点处纵行切开,切除5点至7点间增生的膀胱颈组织。结果:术后平均随访21.5个月,6例患儿肾功能均维持正常,MFR(12.6±1.6)mL/s,肾脏B超检查示双肾轻度积液,无尿失禁,未再次出现膀胱颈梗阻。结论:输尿管镜下膀胱颈电切术治疗小儿先天性膀胱颈梗阻的近期疗效良好,远期疗效尚不明确,有待进一步随访。
Objective: To investigate the clinical value of transurethral resection of bladder neck by electrotomy for the treatment of congenital bladder neck obstruction in children. Methods: The clinical data of 6 patients with congenital bladder neck obstruction undergoing transurethral resection of bladder neck by transurethral resection of bladder neck were retrospectively analyzed from June 2008 to December 2011 in the Department of Urology, the First Affiliated Hospital of Guangzhou Medical College. All 6 children were male, with a mean age of 6.5 years. The main manifestations were dysuria, vesicoureteral reflux and posterior lip of bladder neck. In the 8.0 / 9.8F ureteroscope under direct vision using electric cutting rod at 5 o’clock and 7 o’clock at longitudinal incision, excision of 5 to 7 points between the proliferation of bladder neck tissue. Results: After an average follow-up of 21.5 months, the renal function of 6 children remained normal with MFR (12.6 ± 1.6) mL / s. Kidney B-ultrasound showed mild effusion of both kidneys without incontinence and no recurrence of bladder Neck obstruction. Conclusion: Ureteroscopic transurethral resection of bladder neck for the treatment of children with congenital vesical obstruction of the recent good curative effect, long-term efficacy is not yet clear, pending further follow-up.