经耻骨径路治疗骨盆骨折后复杂性后尿道狭窄  

Treatment of complex posterior urethral strictures with urethroplasty via transpubic approach after pelvic fracture

作　　者：吴国英 王凯 贺金传 

机构地区：[1]解放军第一五二中心医院泌尿外科,平顶山467000

出　　处：《中华创伤杂志》2009年第3期251-253,共3页Chinese Journal of Trauma

摘　　要：目的探讨经耻骨径路治疗骨盆骨折后复杂性后尿道狭窄的手术安全性和长期疗效。方法采用经耻骨径路治疗复杂性后尿道狭窄26例，其中男21例，女5例；年龄16—65岁，平均26岁。后尿道狭窄长度2．5～4．0cm23例，〉4．0cm3例，其中尿道闭锁5例。尿道断端彻底切除瘢痕后采用端端吻合术，观察手术效果及术中术后并发症。结果随访1—7年，平均4年。22例（85％）手术成功，排尿通畅。无耻骨炎、骨盆分离、骨盆不稳定、尿失禁等并发症。1例（4％）排尿不畅，3例（11％）失败。结论经耻骨径路治疗骨盆骨折后复杂性后尿道狭窄安全可行，切除尿道瘢痕彻底，无严重并发症，长期疗效良好，值得临床选择性使用。Objective To evaluate the efficacy and safety of urethroplasty via transpubic approach in treatment of complex posterior urethral strictures after pelyic fracture. Methods Urethroplasty via transpubic approach was done on 26 patients （21 males and 5 females, at mean age of 26 years） with complex posterior urethral strictures. Posterior urethral stricture was 2.5-4.0 cm long in 23 patiens and 〉 4.0 cm in three. There were five patients with urethratresia. The perioperative complications and operative effect were evaluated after the broken ends of the urethra was thoroughly resected and treated with end-to-end anastomosis. Results A follow-up for 1-7 years （ mean 4 years） showed successful operation in 22 patients （85%） , with normal urination and without complications like osteitis pubis, pelvic disassociation, pelvic instability or urinary incontinence. But obstructed urination was found in one （4%） and failed operation in three （11%）. Conclusions Urethroplasty via transpubic approach takes advantages of precise and thorough scar excision, less complications and long term curative effect and is clinically feasible and safe for patients with complex posterior urethral stricture.

关 键 词：骨盆骨折 后尿道狭窄 尿道成形 经耻骨径路 

分 类 号：R699[医药卫生—泌尿科学]