一期输尿管镜下尿道会师术治疗男性闭合性尿道损伤的疗效分析  

The efficacy of immediate urethral realignment with ureteroscope in the treatment of closed urethral injury in male patients

作　　者：陈炳 姜应传 吴海如 邬嘉波 

机构地区：[1]浙江舟山医院泌尿外科

出　　处：《中国男科学杂志》2015年第12期42-44,50,共4页Chinese Journal of Andrology

摘　　要：目的：探讨一期输尿管镜下尿道会师术治疗男性闭合性尿道损伤的方法及疗效。方法回顾性分析2009年1月至2014年12月我院一期输尿管镜下尿道会师术治疗男性患者尿道损伤43例的临床资料，观察其疗效。结果41例一次性完成尿道会师术，2例失败。成功病例平均手术时间（25±6.5）min，拔除导尿管后平均尿流率（20.6±1.4）mL/s。发生尿道狭窄7例。前尿道损伤患者的尿道狭窄发生率、手术时间、住院时间均低于后尿道损伤患者（P＜0.01），术后平均尿流率高于后尿道损伤患者（P＜0.01），尿路感染发生率无明显差异。不完全断裂患者在尿道狭窄发生率、手术时间、住院时间及尿路感染发生率均低于完全断裂患者（P＜0.01），术后平均尿流率高于完全断裂患者（P＜0.01）。结论一期输尿管镜下尿道会师术治疗闭合性尿道损伤安全、有效，值得临床推广。Objective To discuss the technical features of immediate urethral realignment with ureteroscope in the treatment of male patients with closed urethral injury, and evaluate its efficacy.Methods Clinical data of 43 male patients with closed urethral injury who received the ureteroscope in our hospital from January 2009 to December 2014 were retrospectively analyzed. The efficacy of surgery was evaluated.Results Surgery for 41 patients was successful, but 2 failure. For the successful cases, the mean time of operation was （25±6.5）min and the mean urine flow was （20.6±1.4）mL/s, 7 of them got stricture. The mean operating time and hospital stay were shorter in the patients with the anterior urethra than those with posterior urethral tears（P〈0.01）. The mean urine flow in the patients with anterior urethra was higher than that of patients with posterior urethral tears （P〈0.01）. The stricture rate was lower in the patients with anterior urethra than that of the patients with posterior urethral tears（P〈0.01）. There was no significant difference in the infection rate between the patients with anterior urethra or posterior urethral tears. Patients with partial urethra disruption got shorter operating time and hospital stay, lower rate of stricture and infection, and higher urine flow compared with the patients with complete urethra disruption.Conclusion Immediate urethral realignment with ureteroscope is an effective and safe choice for the treatment of the closed urethral injury which is deserved to be applied in clinic .

关 键 词：输尿管镜 尿道会师术 尿道/损伤 

分 类 号：R699.6[医药卫生—泌尿科学]