经尿道腔内技术治疗复杂性尿道狭窄56例  

The treatment of the complicated urethrostenosis by transurethral endoscopic surgery

作　　者：关维民[1] 杨宝龙[1] 鹿尔驯[1] 刘萃龙[1] 张勇建[1] 赵豫波[1] 徐衍盛[1] 

机构地区：[1]解放军海军总医院泌尿外科,北京100048

出　　处：《临床军医杂志》2011年第1期98-100,共3页Clinical Journal of Medical Officers

摘　　要：目的探讨复杂性尿道狭窄经尿道腔内治疗方法及临床效果。方法回顾性总结56例采用冷刀、等离子体双极电切术或激光汽化技术行窥视下经尿道腔内切开、切除尿道瘢痕组织治疗复杂性尿道狭窄的经验。结果 56例1次手术成功率78.57%(44/56);需2～3次手术者12.5%(7/56);腔内手术失败率8.93%(5/56)。手术失败原因为尿道狭窄或尿道闭锁段过长、两断端严重移位、骨盆骨折畸形愈合严重压迫尿道和术后尿道感染。45例(80.36%)获得随访2个月～5年,最大尿流率(Qm ix)均>15m l/s,排尿通畅。结论经尿道腔内手术是治疗复杂性尿道狭窄的有效方法,具有操作简便、创伤小、安全等优点。术前了解尿道狭窄或尿道闭锁段长度、数目、有无假道;术中充分切开并彻底切除瘢痕组织;术后预防感染、正确保留导尿管、定期尿道扩张是保证手术成功的关键。Objective To evaluate the transurethral endoscopic surgery for the complicated urethrostenosis.Methods 56 cases of complicated urethrostenosis by endourethral surgery,such as internal urethrotomy transurethral scar electrosectomy,transurethral scar Plasmakinetic bipolar electrocautery（PKR） and transurethral laser cicatrectomy were retrospectively analyzed.Results The one-stage success rate was78.57%（44/56）,twice or three times was 78.57%（44/56）and the rate of failure was 8.93%.Treating failure for 5 cases was caused by long-segment stricture and urethratresia or severe malposition of the urethral proximal and distal to a narrow-caliber area or post-operation infection.45（80.36 %） cases have been followed up for 2 months～5 years.Satisfactory voiding（Qmix〉15ml/s） have been achieved in all cases.Conclusion Transurethral endoscopic surgery was a safe and efficient treatment of choice for the complicated urethrostenosis.The success of the treatment depends on understanding the length of the stricture before operation,resecting completely the scar tissue with electric,PKR or laser technique during operation,preventing infection and managing appropriately the urethral catheterization after operation.

关 键 词：复杂性尿道狭窄 经尿道手术 绿激光汽化术 等离子体双极电切术 

分 类 号：R695[医药卫生—泌尿科学]