等离子电切联合输尿管镜治疗尿道狭窄的临床分析  

The safety and efficacy of plasma electric resection combined with transurethral ureteroscopy for urethral stricture

作　　者：周杰[1] 毛登久[1] 李杨[1] 蔡韬[1] 

机构地区：[1]怀化医学高等专科学校附属怀化市第三人民医院泌尿外科,湖南怀化418000

出　　处：《中国内镜杂志》2012年第6期633-635,共3页China Journal of Endoscopy

摘　　要：目的探讨应用等离子电切联合输尿管镜治疗尿道狭窄的安全性和疗效。方法 64例尿道狭窄患者根据手术方法分为A、B两组,A组(n=32)应用等离子电切联合输尿管镜治疗,B组(n=32)经会阴或经会阴联合切除耻骨等传统途径行尿道狭窄瘢痕切除端端吻合术。观察两组患者术后排尿及恢复情况。结果两组手术进行顺利,A组出10～30mL、无尿外渗、直肠损伤或尿路感染等并发症,术后28例患者排尿畅通尿流率均大于15mL/s,4例患者行二次手术后排尿通畅。B组出血80～150mL,6例出现伤口感染,1例尿外渗。结论相对传统手术,等离子电切联合输尿管镜治疗尿道狭窄具有视野清晰、出血少、瘢痕组织切除彻底、周围组织损伤小及术后再发生狭窄率低的优点,是微创治疗尿道狭窄的方法之一。[ Objective ] To investigate the safety and efficacy of the plasma electric resection combined with transurethral ureteroscopy for urethral stricture. [Methods ] 64 patients with urethral stenosis were divided into group A and group B, in which group A （n=32） were applicated of the plasma electric resection combined with transurethral ureteroscopy and group B （n=32） with urethral stricture scar were treated traditionally by resection anastomosis with perineal or suprapubic perineal resection. The postoperative urination and recovery were observed in all patients. [Results] The surgery in all patients were successful. There were 10-30 mL of bleeding, no urine extravasation, rectal injury, urinary tract infections and other complications in a group. The urinary voiding flow rate was more than 15 mL/s in 28 patients. And 4 patients voided after secondary surgery. They were 80~150 mL of bleeding and 6 patients had wound infection, and one patient had urinary extravasation in group B. [Conclusion] Compared with the traditional surgery, the methods of treating urethral stricture by the plasma electric resection combined with transurethral ureteroscopy were more clear vision and less bleeding and removal of sear tissue com- pletely with fewer damage in surrounding tissue and lower rate of postoperative recurrence of stenosis. It is the pre- ferred methods for urethral stricture.

关 键 词：尿道狭窄 经尿道等离子电切 筋膜扩张器 输尿管镜 

分 类 号：R693.2[医药卫生—泌尿科学]