小儿泌尿生殖系统异物32例临床分析

Clinical Analysis of Foreign Bodies of the Genitourinary Tract in 32 Children

目的 总结泌尿生殖道异物患儿的诊疗经验.方法 回顾性分析1992年4月至2013年5月我们收治的泌尿生殖系统异物患儿临床资料.共32例（男15例,女17例）患儿,平均年龄7.9岁.异物位于膀胱7例,阴道15例,尿道8例,阴茎根部皮下1例,阴囊内1例.异物种类多样,进入体内方式以患儿自行置入最常见（28例,87.5%）,存留时间最短半天,最长逾1年.经X线摄片诊断12例,B超或联合摄片诊断10例,CT/MRI或联合B超诊断7例,体查诊断2例,内镜检查诊断1例.结果 所有患儿均完整取出异物,治愈出院,随访期内正常排尿.结论 X线摄片及B超为诊断的首选方法,联合CT或内镜检查可有效提高诊断率.临床确诊或高度怀疑泌尿生殖系统异物的患儿应尽早手术,需根据异物的种类、位置及感染情况选择不同的手术方法,内镜为首选,开放手术亦为有效的治疗方式.加强对儿童的看护、教育,正确引导儿童的好奇心,可以预防泌尿生殖道异物.

Obietive To analyze the clinical data of children with foreign bodies in genitourinary tract. Methods A retrospective analysis was conducted on the data of 32 cases of children with foreign bodies in gen- itourinary tract treated by Department of Urology of Children＇s Hospital of Fudan University from April, 1992 to May, 2013. The average age of all patients （15 male, 17 female） was 7.9 years. In 7 cases foreign bodies were in the bladder, 15 in the vagina, 8 in the urethra, 1 beneath the skin of the penis, and 1 in the scrotum. Foreign bodies were in varied types. The most common way for foreign bodies to invade the genitourinary tract was by children themselves （28 cases, 87.5% ）. The shortest remaining time was a half day while the longest over 1 year. 12 cases were diagnosed by plain X-ray, 10 cases by ultrasound or with X-ray, 7 cases by CT/ MRI or with ultrasound, 2 eases by physical examination and 1 case by endoscopy. Results All the foreign bodies were removed completely. M1 the children had normal urination during the follow-up period. Conclu- sion： Plain X-ray and ultrasound are the first choice for diagnosis. Conclusions With CT and/or endoscopic could improve the diagnostic rate. Children diagnosed or highly suspected of foreign bodies of genitourinary tract should operate as soon as possible. Operations should be preformed in accordance with the types, loca- tions and infection status. Endoscopy is the first choice for treatment, while open surgery is also an useful way. Early diagnosis, early treatment and complete removal of foreign bodies are the key points to a good prognosis. Foreign bodies of genitourinary tract can be prevented by strengthening the care and education of children, and correctly guiding the curiosity of children.