复发性尿道狭窄伴假道的分类与处理  

Diagnosis and treatment of recurrent urethral stricture with false passage

作　　者：马全福[1] 曾祥福[1] 袁延年[1] 吴学杰[1] 陈湘龙[1] 贾永中 

机构地区：[1]武警总医院泌尿外科,北京100039

出　　处：《中国微创外科杂志》2006年第5期361-362,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的 评价复发性尿道狭窄伴假道的诊断方法及长期疗效。方法 1990年3月～2005年12月，我院治疗尿道狭窄或闭锁620例，其中伴假道40例（6．4％）。诊断方法：①尿道造影；②经会阴和直肠联合超声动态观察；③自膀胱造瘘管内注入亚甲蓝，同时行尿道镜观察；④CT或MRI检查；⑤打开膀胱探查。手术方法：尿道冷切开后置记忆合金圈10例，电切7例，强行尿道会师4例，液电冲击波治疗8例，后尿道套入术4例，指导患者自行尿道扩张5例，假道憩室切除术1例，会阴尿道造口术1例。结果 40例随访1～15年，平均9年。32例（80．0％）治愈（排尿正常），8例（20．0％）失败，其中为外伤后骨盆不稳定4例。结论 经会阴和直肠联合超声行动态观察假道与正常尿道关系并分类，操作简单，无放射性，长期效果满童．Objective To evaluate diagnostic methods and long - term curative effects for recurrent urethral stricture with false passage. Methods Among a total of 620 cases of urethral stricture or atresia treated from March 1987 to March 2005 in this hospital, false passage was present in 40 cases （6.4%）. Diagnostic methods included urethrography, sonourethrography, injection of methylene blue into the bladder by cystostomy, CT and/or MRI examinations, or exploration by vesicotomy. Surgical methods included insertion of a memory metallic stent after urethrotomy in 10 cases, electrotomy in 7 cases, urethral reunion in 4 cases, hydroelectric shock wave therapy in 8, posterior pull - through urethroplasty in 4, patient self - administered urethral dilation in 5, excision of false passage in 1, and perineourethrostomy in 1. Results All the 40 cases were followed for 1 ～ 15 years （mean, 9 years）. The urethral stricture was cured in 32 cases （80.0%） , and therapeutic failure was observed in 8 cases （20.0%） , including 4 cases of unstable pelvic fracture. Conclusions Sonourethrography is the most accurate noninvasive method of staging urethra strictures. It is simple to perform, requires no radiation, and offers a dynamic three dimensional measurement.

关 键 词：尿道狭窄 假道 尿道闭锁 

分 类 号：R695[医药卫生—泌尿科学]