腔镜下单纯冷刀内切开与联合钬激光治疗男性后尿道狭窄的疗效观察  

Efficacy of holmium laser combined with cold knife endoscopic incision for male posteriorurethral strictures

作　　者：徐汉新 吴兆春 黄海[2] 

机构地区：[1]广东省东莞市清溪医院泌尿外科,广东东莞523640 [2]中山大学孙逸仙纪念医院泌尿外科,广州510120

出　　处：《岭南现代临床外科》2015年第5期610-613,共4页Lingnan Modern Clinics in Surgery

摘　　要：目的 比较腔镜下单纯冷刀内切开与联合钬激光治疗男性后尿道狭窄的疗效及安全性。方法 对26例尿道狭窄患者行单纯行冷刀内切术（冷刀治疗组）,27例患者行冷刀联合钬激光内切开术（联合治疗组）。所有病例随访12-30个月（平均20个月）,比较2组患者手术时间、术后住院天数、术后最大尿流率、狭窄复发率、再手术率及手术并发症发生情况。结果 两组患者手术时间、术后住院天数及术后最大尿流率观察指标,组间比较差异无统计学意义。联合治疗组狭窄复发率（11.1%）明显低于冷刀内切开组（34.6%）,P〈0.05。联合治疗组再手术率（3.7%）也明显低于冷刀内切开组（26.9%）,P〈0.05。两组患者均未见明显手术并发症。结论 内镜下冷刀内切开联合钬激光治疗后尿道狭窄,其疗效及安全性等同单纯冷刀内切开,但远期疗效更好,在复发率及再手术率方面更具优势。Objective To compare the clinical efficacy and safety between cold knife endoscopic incision and combined holmiumLaser with cold knife incision for posterior-urethral stricture.Methods Twenty-six cases of posterior-urethral stricture were assigned cold knife endoscopic incision only,while another 27 cases of posterior-urethral stricture patients were taken combined therapy with holmiumLaser incision and cold knife endoscopic incision.The average follow-up was 20 months（range 12-30 months）.The post-operative clinical data and therapeutic results were compared and analyzed.Results All cases from both groups were treated successfully with no serious bleeding and severe complication.The maximal urinary flow rate in both group was improved after operation.The postoperative hospital stay and the mean operative time had no significant difference in two group（P〉0.05）.The recurrent stricture rate and reoperation rate of combined therapy group were lower than that of cold knife group（P〈0.05）.Conclusion Combined therapy of holmiumLaser endoscopic incision and cold knife incision for posterior-urethral stricture could be a safer and more effective minimally invasive therapeutic modality for posterior-urethral stricture,as compared with the simple cold knife endoscopic incision.

关 键 词：冷刀内切开 钬激光 后尿道狭窄 

分 类 号：R693.2[医药卫生—泌尿科学]