影响口腔黏膜尿道成形治疗复杂性尿道狭窄疗效的相关因素  

Clinical study of buccal mucosa urethroplasty for the treatment of complex urethral stricture

作　　者：刘峰[1] 徐月敏[1] 乔勇[1] 吴登龙[1] 撒应龙[1] 谷宝军[1] 张炯[1] 张心如[1] 金三宝[1] 

机构地区：[1]上海交通大学附属第六人民医院泌尿外科,上海200233

出　　处：《临床泌尿外科杂志》2007年第1期40-42,共3页Journal of Clinical Urology

摘　　要：目的:探讨口腔黏膜尿道成形治疗复杂性尿道狭窄影响疗效的相关因素。方法:对采用口腔黏膜替代尿道成形术76例患者的尿道狭窄位置与长度、口腔黏膜宽度、术前手术次数、支架管留置时间等与狭窄复发率进行单因素分析。结果:76例随访3～60个月,平均24.1个月,术后初期排尿通畅61例(80.3%);再次狭窄15例,其中3例同时伴尿道皮肤瘘,4例伴尿道假性憩室。2例经数次尿道扩张、8例再次手术后排尿通畅,总成功率为93.4%。结论:尿道狭窄复发率与黏膜宽度明显相关(P<0.05)。在0.8～2.0cm范围内口腔黏膜条越宽,尿道狭窄发生率越低;狭窄长度与术前手术次数对短期狭窄复发率无明显影响。Objective：To analyze related factors affecting the treatment outcome of buccal mucosa urethroplasty. Methods.. Between February 2001 and May 2006, 76 patients underwent one-stage onlay buccal mucosa urethroplasty. Variables assumed to influence the success rate of urethroplasty, including stricture localization and length, width of buccal mucosa, previous treatment, duration of catheterization were assessed on univariant analy sis. Results：The patients were followed up for 3-60 months postoperatively（mean, 24.1 months）. Of the 76 patients,61 （80%）voided well, 15 cases developed urethral stricture again. Of the 15 patients, urethrocutaneous fistula was accompanied in 3 and urethral pseudodiverticulum in 4. Ten patients were successfully treated with subse quent procedure,including dilation in 2 and urethroplasty in 8. Including the subsequent procedure, the overall success rate was 94.6 %. Conclusions：Univariate analysis showed that the width of buccal mucosa was associated with the success rate of urethroplasty（ P 〈0.05）.

关 键 词：尿道狭窄 尿道成形术 口腔黏膜 

分 类 号：R693.4[医药卫生—泌尿科学]