阴囊型尿道下裂术中不同膀胱引流方式比较  

Comparison of different Bladder drainage options in urethroplasty for the treatment of scrotal hypospadias

作　　者：张雄[1] 张孝斌[1] 饶婷[1] 余伟民[1] 

机构地区：[1]武汉大学人民医院泌尿外科,430060

出　　处：《临床外科杂志》2010年第12期846-847,共2页Journal of Clinical Surgery

摘　　要：目的 探讨阴囊型尿道下裂一期手术中,三种膀胱引流方式的疗效.方法 回顾性分析2001年1月至2009年1月间阴囊型尿道下裂一期尿道成形手术患者93例.根据引流方式分为耻骨上膀胱穿刺造瘘联合支架管组（A组,43例）、自制引流管联合Foley导管组（B组,19例）和单纯Foley导管组（C组,31例）.对比观察三组术后尿道皮肤瘘发生率和膀胱刺激征发生率.结果 A、B、C组尿瘘发生率分别为13.95%、10.53%、38.71%;A、B组尿瘘发生率低于C组,差异有统计学意义（P＜0.05）;膀胱刺激征发生率分别为44.19%、15.79%、19.35%.B、C组膀胱刺激征发生率低于A组,差异有统计学意义（P＜0.05）.结论 对阴囊型尿道下裂一期尿道成形手术患者,自制引流管联合Foley导管引流,可降低膀胱刺激征和尿道皮肤瘘发生率.Objective To compare the therapeutic effects of 3 bladder drainage options for scrotal hypostasis in one - stage urethroplasty. Methods From January 2001 to January 2009,93 scrotal hypostasis patients in one - stage urethroplasty were recruited into this retrospective outcome analysis. Patients were divided into 3 groups ： group A （ n = 43 ） in which drainage was performed by paracentetic suprapubic cystostomy by using urethral stents; group B （n = 19 ） in which the patients were subjected to drainage by transurethral catheterization with Foley and home- made urethral drainage tube; group C （n = 31 ） in which the patients received drainage by transurethral catheterization with Foley. We compared 3 methods in terms of the incidence of irritation sign of bladder and the incidence of urethral fistula. Results The incidences of urethral fistula in the three groups were 13.95 % , 10.53 % and 38.71% , respectively. Group A and group B had significantly lower incidence of urethral fistula than group C （ P 〈 0.05 ）. The incidences of irritation sign of bladder in the three groups were 44.19% , 15.79% and 19.35% ,respectively. Group B and group C had significantly lower incidence of irritation sign of bladder than group A （P 〈 0.05 ）. Conclusion Transurethral catheterization with Foley and home - made urethral drainage tube is a good choice for drainage in scrotal hypostasis patients in one - stage urethroplasty, with lower irritation sign of bladder and lower incidence of urethral fistula.

关 键 词：阴囊型尿道下裂 尿道成形术 膀胱引流 

分 类 号：R736.1[医药卫生—肿瘤]