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[后尿道瓣膜——诊断及初始治疗考量]

[Posterior urethral valves--diagnosis and primary treatment considerations].

作者信息

Tîrlea S, Ionescu S

机构信息

Clinica de Chirurgie PediatricS, Spitalul Clinic de Urgenţă pentru Copii Maria Sklodowska Curie, U.M.F. Carol Davila, Bucureşti România.

出版信息

Chirurgia (Bucur). 2012 Mar-Apr;107(2):218-25.

Abstract

Posterior Urethral Valves--PUV are the most common cause of bladder outflow obstruction in male infants, representig about 10% of prenatally detected hydronephrosis. The medical records of 27 patients, admitted and treated in the pediatric urology department of "Maria Sklodowska Curie" Emergency Hospital for Children, Bucharest, between 2001-2010 where reviewed. The aim of the study is to discuss the endoscopic valve ablation as the first choice treatment of PUV. Twenty-six, (96%) of ouer patients are alive, having now different ages, with serum creatinine levels < 0.8 mg/dl, at successive controls. One patient, lyear 11 mounths old, died in the pediatric nephrology department after right nephrec-tomy and left ureterostomy, 9 mounth before. Mortality rate in PUV patients has significantly decreased in the last 30 years, from 50% to less than 10% of patients. Nonetheless, morbidity related to PUV still represent an heavy burden for these patients and their doctors. Urodynamic studies help in understanding the pathophysiology of valve bladder and its effect on the urinary tract at long term follow-up.

摘要

后尿道瓣膜——后尿道瓣膜是男性婴儿膀胱出口梗阻最常见的原因,约占产前检测到的肾积水的10%。回顾了2001年至2010年间在布加勒斯特“玛丽亚·斯克沃多夫斯卡·居里”儿童医院小儿泌尿外科收治和治疗的27例患者的病历。本研究的目的是讨论内镜下瓣膜切除术作为后尿道瓣膜的首选治疗方法。在连续的检查中,我们的26例(96%)患者存活,年龄各异,血清肌酐水平<0.8mg/dl。一名1岁11个月大的患者在右肾切除和左输尿管造口术后9个月,于小儿肾病科死亡。在过去30年中,后尿道瓣膜患者的死亡率显著下降,从50%降至不到10%。尽管如此,与后尿道瓣膜相关的发病率仍然给这些患者及其医生带来沉重负担。尿动力学研究有助于在长期随访中了解瓣膜膀胱的病理生理学及其对尿路的影响。

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