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女性儿童尿道黏膜脱垂的诊治情况分析 被引量:1

Diagnosis and treatment of urethral mucosa prolapse in female children
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摘要 目的分析女性儿童尿道黏膜脱垂的临床特点并总结治疗经验。方法回顾性分析2007年1月至2017年12月浙江大学医学院附属儿童医院诊断为尿道黏膜脱垂的102例女性患儿的临床资料。年龄8~156个月,中位年龄80个月;主诉为黏膜出血57例,无症状性尿道口肿块31例,排尿异常(包括排尿困难或伴尿频、尿急、尿痛)14例。102例中89例查体可见典型的"甜甜圈"样表现,即尿道外口处环形的紫红色或略暗红色肿块,凸出于小阴唇间,遮挡阴道外口,尿道外口位于肿块中部;13例表现不典型,借助导尿管,以及B超、MRI或术中膀胱镜等检查确诊。58例因肿块小仅予坐浴治疗;39例因肿块大予表面麻醉下脱垂黏膜回纳,辅以坐浴治疗;5例首诊时因黏膜嵌顿发黑坏死而行手术治疗,手术方式采用黏膜四象限切除术。结果97例经保守治疗后,其中89例(87.3%)治愈,8例症状反复发作行手术治疗。共13例经手术治疗,术后无尿道狭窄、活动性出血、尿道黏膜脱垂复发等。结论女性儿童尿道黏膜脱垂临床表现主要以会阴部出血和无症状性尿道口肿物为主,大部分患儿查体可见"甜甜圈"样表现从而确诊。本病经保守治疗后大部分能治愈,保守治疗后仍反复发作或初次发作伴黏膜嵌顿坏死者可行手术切除治疗,手术简单易行,术后效果佳,并发症少。 Objective To review the clinical characteristics of urethral prolapse in female children and summarize our experience of treatment. Methods A retrospective analysis of the clinical characteristics of 102 patients with urethral prolapse from January 2007 to December 2017 was conducted at The Children’s Hospital of Zhejiang University School of Medicine. The age of the patients ranged from 8-156 months with an median of 80 months. The presenting symptoms in the 102 girls were: bleeding in 57 patients (55.9%), mass in 31 patients (30.4%), and dysuria/ urinary frequency, urgent and pain in 14 patients (13.4%). In all, 58 patients were managed conservatively with Sitz baths as their masses were small, 39 underwent prolapse reduction under topical anesthesia and Sitz baths because their mass were large, and 5 patients were treated by excision of the prolapsed urethral mucosa with four-quadrant excisional technique because thrombosed urethral prolapse at first visit. Results A total of 89 patients were cured after conservative treatment (87.3%), 8 patients were converted to surgical treatment because frequent recurrence with conservative treatment. No urethral stricture, active hemorrhage and recurrent were found in 13 patients after operation. Conclusions The most common clinical manifestations of urethral prolapse are urethral mass and bleeding. Most patients can be cured by conservative treatment. The patients whose symptoms were severe or suffered from frequent recurrence of urethral prolapse should be managed with surgical excision.
作者 杨帆 沈一丁 陶畅 陈光杰 吴德华 黄勇 徐哲明 唐达星 Yang Fan;Shen Yiding;Tao Chang;Chen Guangjie;Wu Dehua;Huang Yong;Xu Zheming;Tang Daxing(Department of Pediatric Urology Surgery, The Children’s Hospital of Zhejiang University School of Medicine, Hangzhou 310052, China)
出处 《中华泌尿外科杂志》 CAS CSCD 北大核心 2019年第8期611-614,共4页 Chinese Journal of Urology
关键词 尿道疾病 黏膜脱垂 儿童 女性 治疗 Urethral diseases Mucosa prolapse Child Female Treatment
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