后尿道瓣膜症术后疗效的相关因素分析

The factors influencing the effectiveness of transurethral resection of posterior urethral valve

目的:通过观察后尿道瓣膜症(PUV)术后临床指标的变化,分析影响手术疗效的相关因素。方法:回顾性分析2003年1月至2017年3月广西医科大学第一附属医院小儿外科收治的31例PUV患儿的临床资料,随访观察术后临床指标,包括排尿情况、尿流率、残余尿、尿路感染、膀胱形态、肾及输尿管积水、膀胱输尿管反流、肾功能等,对各指标予以评分,制定标准化量表,从而评价手术疗效,并对影响疗效的相关因素进行Fisher确切概率法统计分析。结果:全组获得随访25例,其中术后膀胱功能评估良好17例,中等5例,差3例。影响PUV手术疗效的各个因素中,瓣膜类型、发病早晚、术前肾及输尿管积水、术前膀胱输尿管反流对疗效无明显影响(均P>0.05),而术前肾功能、产前诊断、术前膀胱形态对疗效的影响显著(均P<0.05)。结论:术前肾功能损害、术前膀胱形态改变及产前诊断是影响PUV手术疗效的重要因素。

Objective：To observe the changes of clinical indexes after transurethral resection of posterior urethral valve（PUV）,and analyze the factors influencing the effectiveness of the surgery.Methods：The clinical data of 31 children with PUV in our hospital from January 2003 to March 2017 were retrospectively analyzed.The postoperative clinical indexes such as urinary flow rate,residual urine,urinary tract infection,bladder morphology,renal and ureteral hydronephrosis,bladder and ureteral reflux,renal function etc.were observed and scored,in order to evaluate the efficacy of the surgery.Results：A total of 25 cases were followed-up.Postoperative bladder function was good in 17 cases,fair in 5 cases and poor in 3 cases.The preoperative renal function,prenatal diagnosis and preoperative bladder morphology exhibited a significant effect on postoperative efficacy（P〈0.05）,while the factors including valve type,onset time,preoperative kidney and ureteral hydronephrosis,and preoperative vesicoureteral reflux had no obvious effect on postoperative efficacy（P 〉0.05）.Conclusion：Preoperative renal function,prenatal diagnosis and preoperative bladder morphology were the factors influencing postoperative outcome of PUV.