开放与气膀胱腹腔镜下膀胱输尿管再植术治疗小儿膀胱输尿管反流的临床疗效研究

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目的 :探讨开放与气膀胱腹腔镜下膀胱输尿管再植术治疗小儿膀胱输尿管返流的临床疗效。方法 :选择2012年1月~2015年8月在我院治疗的膀胱输尿管反流患儿80例,按照手术方式将患儿分为两组,气膀胱组和开放组,每组40例,气膀胱组接受气膀胱腹腔镜膀胱输尿管再植术,开放组患儿接受开放式膀胱输尿管再植术。观察两组患儿的手术情况,同时比较两组患儿的近期、远期临床疗效。结果 :气膀胱组患儿的手术切口较开放组明显较小,气膀胱组患儿术中出血量较开放组少,比较两组患儿手术进行的时间发现气膀胱组患儿手术时间较开放组明显延长;气膀胱组患儿术后导尿管滞留、术后血尿、禁食、使用抗生素以及术后住院时间等指标与开放组比较明显较短;两组患儿术后输尿管直径基本一致,差异无统计学意义。随访期间,两组患儿均未发生明显的不良事件,仅开放组发生3例漏尿患儿。结论 :气膀胱腹腔镜下膀胱输尿管再植术治疗小儿膀胱输尿管尿液反流临床疗效显著,利于患儿术后恢复,值得临床推广应用。 Objective: To investigate the clinical efficacy of open and gas-assisted laparoscopic vesicoureteral replantation in the treatment of vesicoureteral reflux in children. Methods: Eighty children with vesicoureteral reflux were treated in our hospital from January 2012 to August 2015. The children were divided into two groups according to the method of operation. The patients were divided into two groups: gas-cyst group and open group, 40 cases in each group. The bladder group received laparoscopic bladder ureter replantation, and the open group received open vesicoureteral replantation. Observe the operation condition of two groups of children, and compare the short-term and long-term clinical curative effect of both groups. Results: The surgical incision in children with bladder bladder was significantly smaller than that in open group. The bleeding volume in patients with bladder bladder was lower than that in open group. Comparing the operation time of the two groups, the operation time of children with bladder group was shorter than that of open group Group of patients with bladder bladder after catheter retention, postoperative hematuria, fasting, the use of antibiotics and postoperative hospital stay and other indicators were significantly shorter compared with the open group; two groups of children with consistent ureteral diameter ,The difference was not statistically significant. During follow-up, no significant adverse events occurred in both groups, with only three cases of leakage of urine in the open group. Conclusion: Bladder ureter laparoscopic transurethral resection of vesicoureteral urethrocyte surgery in children with significant clinical efficacy of urine reflux, which will help patients with postoperative recovery, it is worthy of clinical application.
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