采用导引钢丝进行儿童膀胱镜经尿道电切治疗

The role of the steel guiding wire in children's posterior urethral valve ablation and ureterocele incision via cystoscope

目的介绍采用导引钢丝进行膀胱镜经尿道的后尿道瓣膜和输尿管囊肿电切方法。方法21例后尿道瓣膜和13例输尿管囊肿患儿,应用外套3Fr输尿管导管的导引钢丝在膀胱镜直视下经尿道进行瓣膜或囊肿电切。结果电切所用时间为15～20min。21例后尿道瓣膜患儿术后排尿性膀胱尿道造影复查显示瓣膜完全消失,无尿道狭窄;13例输尿管囊肿患儿术后B超显示囊肿均已消失。结论采用导引钢丝进行膀胱镜经尿道电切手术安全、有效、简便、迅速,适用于儿童尤其是新生儿和婴幼儿后尿道瓣膜或输尿管囊肿的治疗。

Objective To introduce the technique of steel guiding wire to ablate posterior urethral valve and incise ureterocele endoscopically.Methods 34 pediatric patients included 21 with posterior urethral valves and 13 ureteroceles. The steel guiding wire wrapped in 3 Fr ureteral catheter and connected to electric current was used transurethrally to cut the valves and create openings 0.5 cm in length on the ureterocele.Results The procedure duration was about 15-20 min. In follow-up, 21 posterior urethral valves totally disappeared in voiding cystourethrogram, the children could micturate easily without any stricture. The ultrasound could not find any ureterocele in 13 ureterocele children.Conclusion This transurethral ablation and incision via cystoscope is safe, effective and easy to perform for the treatment of children, especially newborns and young infants with posterior urethral valve and ureterocele.