263例后尿道损伤的早期治疗  

Early management of 263 cases of posterior urethral injury

作　　者：赵英奇[1] 范玉铃[1] 

机构地区：[1]天津市第一中心医院泌尿外科,300192

出　　处：《中华创伤杂志》2000年第9期521-523,共3页Chinese Journal of Trauma

摘　　要：目的　探讨后尿道损伤早期安全、合理、有效的治疗方法。　方法　对 2 6 3例后尿道损伤的早期处理进行回顾性分析 ,尿道不全断裂行尿道插管成功 2 1例 ;尿道完全断裂行尿道会师术 (包括会师 +Foley尿管牵引术 ) 178例 ,尿道吻合术 11例 ;病情危重者仅行耻骨上膀胱造瘘术 5 3例。　结果　留置尿管的 2 1例中 ,排尿通畅 18例 ,排尿接近正常 2例 ,失败 1例 ;15 1例 (84.8% )行尿道会师术者得到治愈 ;9例 (81.8% )行尿道吻合术者得到治愈 ;耻骨上膀胱造瘘术者后期均形成尿道闭锁。　结论　后尿道损伤的早期治疗宜根据病人具体情况作出选择。尿道会师术操作简便、创伤小、并发症少 ,可及时恢复尿道的连续性 ,是早期处理后尿道损伤较为合理、有效的首选方法。对病情危重者 ,以耻骨上膀胱造瘘术为宜。Objective To explore safe and effective managements for posterior urethral injury. Methods Early treatment of 263 cases of posterior urethral injury has been studied retrospectively. Simple catheterization was adopted in 21 cases of partial disruption, urethral reunion operation with or without a Foley catheter traction in 178 cases, prompt urethral anastomosis in 11,simple cystostomy in 53. Results Among 21 patients with simple catheterization, 18 had normal urination,2 needed several dilatation after the initial management. 1 failed. The success rate for urethral reunion operation with or without a Foley catheter traction was 84.8%.The success rate for prompt urethral anastomosis was 81.8%. Conclusions Urethral reunion operation has the advantages of simple, easy to use, good effect, small trauma and less complications, and is the first option for urethral injury. For serious and risk patients, suprapubic cystostomy is advisable.

关 键 词：后尿道损伤 早期治疗 尿道会师术 

分 类 号：R695[医药卫生—泌尿科学]