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目的探讨Cohen术治疗小儿膀胱输尿管返流的临床疗效。方法 2003年6月至2008年12月我院对收治的32例膀胱输尿管返流患儿行Cohen手术。其中男20例,女12例;年龄3个月～9岁,<1岁者9例,1～3岁者13例,>3岁者10例。结果 32例患儿均于Cohen术后半年行排泄性膀胱尿道造影(VCUG)检查,其中2例出现膀胱输尿管返流,成功率为93.75%。泌尿系感染、发热等症状消失,尿失禁症状明显改善,6例行膀胱镜检见术侧输尿管口呈“火山口型”。结论 Cohen术式不干扰膀胱外组织及支配膀胱运动的盆底神经丛,创伤少,并发症少,解剖清楚,术野清晰,手术成功率高,是治疗儿童膀胱输尿管返流的标准术式。
Objective To investigate the clinical efficacy of Cohen for the treatment of vesicoureteral reflux in children. Methods From June 2003 to December 2008, 32 patients with vesicoureteral reflux admitted to our hospital underwent Cohen operation. Including 20 males and 12 females; aged 3 months to 9 years old, <1 year old in 9 cases, 1 to 3 years old in 13 cases,> 3 years old in 10 cases. Results All 32 patients underwent examinations of excretory vesicourethrography (VCUG) six months after Cohen. Among them, vesicoureteral reflux occurred in 2 cases, with a success rate of 93.75%. Urinary tract infection, fever and other symptoms disappeared, urinary incontinence symptoms improved significantly, 6 cases of cystoscopy ureteropelvic was “caldera”. Conclusions Cohen procedure does not interfere with bladder tissue and the pelvic floor plexus that dominate bladder movement. It has less trauma, less complications, clear anatomy, clear operative field and high operation success rate. It is the standard procedure for the treatment of urinary vesicoureteral reflux in children.