直视下尿道内切开术后再次狭窄20例分析  

Analysis of 20 Cases with Secondary Urethral Stricture after Direct Visual Internal Urethrotomy

作　　者：彭启伦[1] 夏川[1] 张洪敏[1] 杨凡[1] 潘向东[1] 彭海涛[1] 

机构地区：[1]峨眉山市人民医院泌尿外科,四川614200

出　　处：《西南军医》2011年第2期217-219,共3页Journal of Military Surgeon in Southwest China

摘　　要：目的对直视下尿道内切开术(DVIU)的术后疗效进行分析,重新认识DVIU的手术适应证,探索降低DVIU术后再次狭窄的方法。方法回顾性分析2004年1月至2009年4月78例尿道狭窄行DVIU术临床资料,对DVIU术后再次尿道狭窄病例进行分析,术前狭窄长度≤1.0㎝15例,1.1～2㎝42例2,～2.5㎝15例,≥2.5㎝6例,狭窄部位后尿道42例、前尿道36例,尿道球部2例。结果 DVIU1次成功70例,2次成功8例,术中加用电切12例,术后留置尿管时间3天～3月。术后随访1年,再次发生尿道狭窄20例,其中术后3月9例,术后半年11例。结论选择≤1㎝的尿道狭窄作为手术适应证,术中轻柔操作,合理选择留置尿管时间等,能降低DVIU术后再次尿道狭窄的复发率,应当有选择性地应用DVIU。Objective To analyze the curative effect of direct visual internal urethrotomy（DVIU） and to explore the way to avoid secondary stricture after DVIU. Methods A retrospective analysis was made to the clinical data of 78 cases with urethral stricture being treated by DVIU from Jan.,2004 to April,2009,and the cases with secondary stricture after DVIU were selected for analysis;before operation,there were 15 cases with the stricture length ≤1.0cm,42 cases with the stricture length of 1.1～2cm,15cases with stricture length of 2～2.5cm and 6 cases with the stricture length ≥2.5cm;42 cases had the stricture located in posterior urethra,36 cases in anterior urethra and 2 cases in urethral bulb. Result 70 cases had DVIU successfully for only once while 8 cases had DVIU for twice;electrotome was applied in DVIU of 12 cases;the time of indwelling catheter lasted from 3 days to 3 months;follow-up lasted for 1 year,and 20 cases suffered from secondary stricture： 9 cases 3 months after DVIU and 11 cases half a year after DVIU. Conclusions Urethral stricture ≤1cm is the indication for DVIU and correct time length of catheter indwelling can reduce the reoccurrence of secondary urethral stricture after DVIU;DVIU should be applied selectively.

关 键 词：直视下尿道内切开术 尿道狭窄 

分 类 号：R695[医药卫生—泌尿科学]