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作 者:黄小佳[1] 邱建忠[1] 李春[1] 丘捷文[1] 文博[1] 彭瑞[1]
机构地区:[1]深圳市第八人民医院泌尿外科,广东深圳518101
出 处:《中华男科学杂志》2009年第6期542-544,共3页National Journal of Andrology
摘 要:目的:探索一种更安全、简便的治疗创伤性尿道断裂的手术方法。方法:对18例后尿道损伤和4例尿道球部断裂病例先作膀胱穿刺造瘘,后用尿道导引器以导引和会师的方法完成尿道会师术。结果:22例中21例完成会师手术,1例因合并膀胱破裂改为开放手术。18例硬膜外麻醉和3例局部麻醉下完成手术;平均手术时间18min,平均术中出血20ml,术后常规尿道扩张3月。21例获随访3月至2年,最大尿流率(MFR):15~22ml/s有13例,10~14ml/s有7例,1例因瘢痕狭窄术后3个月后行尿道吻合术。结论:穿刺导引法尿道会师术简便易行,减少了麻醉和术中损伤风险,可在局麻下施行,值得推广。Objective: To search for a safe and convenient surgical method for management of urethral disruption. Methods: We performed urethral realignment for 18 cases of posterior urethral disruption and 4 cases of ruptured bulbous urethra using the urethral guidance probe following bladder puncture stoma. Results: Urethral realignment was accomplished in 21 of the cases, 18 under epidural and 3 under local anesthesia, with the mean blood loss of 20 ml and the average operation time of 18 minutes. Open surgery was necessitated in 1 ease due to the complication of bladder rupture. Routine postoperative urethral dilation extended for 3 months, and all the cases were followed up for 3 to 24 months. The maximum urine flow rate was 15 -22 ml/s in 13 cases and 10 - 14 ml/s in 7. One case received urethral anastomosis 3 months later because of urethrostenosis. Conclusions: Urethral realignment with the urethral guidance probe is a safe, convenient and effective surgical strategy for the management of urethral disruption.
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