腹腔镜,膀胱输尿管反流,输尿管再植,小儿 ," /> 腹腔镜,膀胱输尿管反流,输尿管再植,小儿 ,"/> Laparoscope,Vesicoureteral reflux,Ureteral reimplantation, Children ,"/> <div> <span style="line-height:2;font-size:14px;">腹腔镜 Lich-Gregoir 技术治疗小儿</span><span style="line-height:2;font-size:14px;">原发性膀胱输尿管反流的临床研究</span> </div>
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发育医学电子杂志  2020, Vol. 8 Issue (3): 262-266    DOI: 10.3969/j.issn.2095-5340.2020.03.013
  结构畸形   临床经验交流 |
腹腔镜 Lich-Gregoir 技术治疗小儿原发性膀胱输尿管反流的临床研究
马立飞 周辉霞 周晓光 等
解放军总医院第七医学中心八一儿童医院 泌尿外科,北京 100700
Clinical study of laparoscopic Lich-Gregoir technique for the treatment of primary vesicoureteral reflux in children
Ma Lifei, Zhou Huixia, Zhou Xiaoguang, et al
Department of Urology,Bayi Children’s Hospital, the Seventh Medical Center of PLA General Hospital, Beijing 100700, China
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摘要 
【摘要】 目的  探讨腹腔镜 Lich-Gregoir 技 术 治 疗 小 儿 原 发 性 膀 胱 输 尿 管 反 流(vesicoureteral
reflux, VUR)的临床疗效。 方法 回顾性分析 2009 年 9 月至 2015 年 9 月在解放军总医院第七医学中
心八一儿童医院接受腹腔镜 Lich-Gregoir 技术治疗的 30 例 VUR 患儿的临床资料。建立 CO2 气腹,于
脐上缘置入 5 mm 目镜 Trocar 并固定,两侧放置 3 或 5 mm Trocar。切开患侧膀胱浆肌层约 3 ~ 5 cm,
包埋输尿管形成膀胱外黏膜下隧道,术后留置导尿 3 ~ 5 d。术后定期随访超声、肾图及排泄性膀胱造
影检查。 结果  30 例患儿中男 17 例,女 13 例;左侧 16 例,右侧 10 例,双侧 4 例,共 34 根输尿管;年
龄 6 ~ 144 个月,平均(39.5±10.2)个月。30 例腹腔镜 Lich-Gregoir 技术治疗 VUR 的手术均成功,无中转开放手术。单侧输尿管手术平均用时(53±10)min,双侧输尿管(93±19)min。术中出血量平均(10±2)ml。轻度血尿 3 例,2 ~ 4 d 后消失。所有患儿术后均排尿良好,未出现尿潴留。术后随访 1 例双侧输尿管移植术后患儿出现单侧膀胱输尿管反流Ⅰ级,因无泌尿系感染、腹痛、发热等不适症状,随诊观察,术后 30 个月复查排泄性膀胱造影提示无膀胱输尿管反流。 结论 腹腔镜 Lich-Gregoir 技术治疗小儿 VUR 安全、有效,可不改变输尿管纵形走行方向,术后恢复快,具有微创、美容等优势。
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Abstract: 
【Abstract】 Objective To explore the clinical experiences of laparoscopic Lich-Gregoir technique in
the treatment of children with primary vesicoureteral reflux (VUR). Methods Clinical data of 30 cases of children with primary VUR in Bayi Children's Hospital, the Seventh Medical Center of PLA General Hospital between September 2009 and September 2015 were analyzed retrospectively. A Trocar (5 mm) was inserted through umbilicus into the abdominal cavity and other 2 trocars (3 or 5 mm) were inserted
through paraumbilical two sides. Electrical surgery unit was used to cut muscular layer. Detrusor tunnel
was approximately 3-5 cm. A foley catheter was inserted for drainage for 3-5 days postoperatively. All
patients were postoperatively followed up with ultrasoundgraphy, diuretic renal dynamic imaging and
urinary excretory cystography. Results The study population consisted of involving 17 male and 13
females, left side 16 cases, right side 10 cases, and bilateral sides 4 cases, 34 sides were noted in all. The
mean age was (39.5±10.2) months (6-144 months). All procedures were completed without conversion to
open surgery. The mean operation time of unilateral ureter were (53±10) min and that of bilateral ureters
were (93±19) min. The mean estimated blood loss was (10±2) ml. Mild hematuria occurred in 3 cases
and disappeared 2-4 d later. All patients had good urination after operation without urinary retention.
One case undertaking bilateral ureteral transplantation was found unilateral VUR grade I , and was
followed up due to no urinary infection, stomachache, fever and other symptoms. The VUR gradeI was disappeared at 30 months after surgery. Conclusions Laparoscopic Lich-Gregoir techniquein the treatment of children with primary VUR is a safe and effective approach, presenting someadvantages including rapid postoperative recovery, original direction of the ureter, minimally invasive,and satisfactory cosmetics
Key words:  Laparoscope')" href="#">
收稿日期:  2019-03-06                出版日期:  2020-07-30      发布日期:  2020-07-28      期的出版日期:  2020-07-30
基金资助: 
军队计生专项(18JS001)
通讯作者:  周辉霞https://baike.baidu.com/item/周辉霞/15799773?fr=aladdin    E-mail:  huixia99999@163.com
引用本文:    
马立飞 周辉霞 周晓光 等.
腹腔镜 Lich-Gregoir 技术治疗小儿原发性膀胱输尿管反流的临床研究
[J]. 发育医学电子杂志, 2020, 8(3): 262-266.
Ma Lifei, Zhou Huixia, Zhou Xiaoguang, et al.
Clinical study of laparoscopic Lich-Gregoir technique for the treatment of primary vesicoureteral reflux in children
. Journal of Developmental Medicine(Electronic Version), 2020, 8(3): 262-266.
链接本文:  
http://www.fyyxzz.com/CN/10.3969/j.issn.2095-5340.2020.03.013  或          http://www.fyyxzz.com/CN/Y2020/V8/I3/262
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内镜下输尿管口注射聚糖酐透明质酸共聚物治疗小儿膀胱输尿管反流的临床研究
[J]. 发育医学电子杂志, 2020, 8(3): 234-238.
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