女性先天性后尿道瓣膜的诊断及治疗（附1例报告）

Diagnosis and treatment of congenital posterior urethral valve of the female （1 case report attached）

目的 探讨女性先天性后尿道瓣膜的临床诊断及治疗.方法 回顾性分析1例女性先天性后尿道瓣膜的临床资料：患儿女性,7个月,足月剖宫产,因反复发热6个月就诊.家属否认其他病史.患儿出生后约30d因发热在当地综合性医院以“急性上呼吸道感染”行抗感染治疗,症状好转；但反复发作,约15 ～ 30d发作一次,至7个月大时再次因发热住院,尿常规提示白细胞＋＋＋,彩超提示：双肾积水,双侧输尿管扩张,抗感染治疗发热控制后转诊本院；膀胱镜检发现膀胱颈后壁黏膜酷似二尖瓣样皱起,膀胱壁小梁纵生,输尿管间峭肥厚,行瓣膜切开术.结果 术后排尿通畅,未再发热,双肾积水明显减轻.随访至今患儿发育良好,未再发作类似病史,双肾积水消失.结论 女性后尿道瓣膜由于十分罕见导致诊断相对较困难,且并发症严重；如早期能及时发现,手术是解除的唯一方法,且愈后良好.但要提高认识,术后要跟踪随访.

Objectives To investigate the female the clinical diagnosis and treatment of congenital posterior urethral valve. Methods Retrospective analysis the clinical data of I case women congenital posterior urethral valve： women, children, seven months, full term cesarean delivery, because of repeated fever clinic with 6 months. Family denied other medical history. Children with fever, about 30 days after he was born in local general hospital to do anti infection treatment of acute upper respiratory tract infection, symptoms get better; But break out repeatedly, about 15 to 30 days time, and 7 months old because of fever in the hospital again, routine urine the leu cocytes ＋ ＋ ＋ , Color Doppler Ultrasonic： double kidney seeper, bilateral ureteral expansion, anti infection treatment after heating control referral hospital; Found microscopic examination of the bladder wall of bladder neck mucosa wrinkled like mitral valve samples, bladder wall trabecular ZongSheng, ureteral forms between hypertrophy, valvotomy. Results Postoperative micturition unobstructed, have fever again, double kidney seeper significantly reduce. Follow up of children with well developed, not yet to attack similar to the history, double kidney seeper disappear. Conclusions Women posterior urethral valves diagnosis is relatively difficult, due to a rare and seri ous complications; Such as timely found that early surgery is the only way to lift, and the more good. But to raise awareness and to track with the proof.