带鞘膀胱镜急诊治疗闭合性尿道球部损伤  

Emergency treatment of closed bulbus urethral injury by cystoscope with a sheath

作　　者：孙道冬[1] 颜加强[1] 蒙明森[1] 刘元丰[1] 封建立[1] 舒勇[1] 康元上[1] 李靖[1] 王勤[1] 胡威[1] 任建[1] 孙丹宁[1] 

机构地区：[1]解放军324医院泌尿肾病中心,重庆400020

出　　处：《中国内镜杂志》2013年第1期63-65,共3页China Journal of Endoscopy

摘　　要：目的探讨带鞘膀胱镜在急诊治疗闭合性尿道球部损伤中的疗效。方法对57例闭合性尿道球部损伤病例急诊行带鞘膀胱镜下尿道会师术治疗,并对临床资料进行回顾性分析。结果 19例门诊治疗,住院治疗38例,平均手术时间15min(10～45min),平均住院天数6d(4～13d)。57例尿道损伤患者均能顺利留置尿管,术后4～8周拔除尿管。11例尿道完全断裂患者中,4例通过膀胱造瘘术以尿道探子加以指示后顺利置管。53例拔管后排尿通畅,常规定期尿道扩张1～3个月后最大尿流率18～25mL/s;3例发生尿道狭窄,定期尿道扩张3～6个月后最大尿流率16～23mL/s;1例拔管3个月后尿道严重狭窄,行冷刀内切开、尿道瘢痕汽化电切术治疗后排尿通畅。结论带鞘膀胱镜尿道会师术具有操作简便、损伤小、手术时间短、可门诊操作、有效恢复尿道连续性的优点,可用于闭合性尿道球部损伤的急诊治疗。【Objective】To explore the efficiency of emergency treatment of closed bulbus urethral injury by cystoscope with a sheath. 【Methods】The clinical data of 57 cases of bulbus urethral injury treated by cystoscope with a sheath were retrospectively analyzed. 【Results】19 outpatients and 38 inpatients endured the emergency treatment. The average operation time was 15 mins （10～45 mins） and the average admission day was 6 days （4～13 days）. The catheters were successfully inserted into all patients with urethral injury and were removed within 4 ～8 weeks after the operation. Urethral probe was used for guidance after suprapubic cystostomy in 4 complete disruptions. 53 cases had fluent urination after the removal of catheter and received regular urethral expansion within 1～3 months and their maximum urine flow rate was 18～25 mL/s at the end of the treatment. 3 cases with urethral stricture received urethral expansion within 3～6 months and their maximum urine flow rate was 16～23 mL/s at the end of the treatment. Only one case had serious urethral stricture after the removal of catheter and received transurethral urethrotomy by cold knife and transurethral scar vaporization.【Conclusion】Urethral realignment by cystoscope with a sheath is minimally invasive,demanding shorter operation time and admission day, can be used for outpatients , and can effectively resume the urethral continuity, therefore it could be used for emergency treatment for closed bulbus urethral injury.

关 键 词：尿道损伤 腔镜下尿道会师术 急诊治疗 

分 类 号：R695[医药卫生—泌尿科学]