尿道海绵体非离断尿道吻合术在骨盆骨折引起后尿道狭窄中的初步应用  

A preliminary clinical study on non-transecting urethroplasty for the treatment of posterior urethral stricture caused by pelvic fractures

作　　者：李超[1] 刘博[1] 乐威[1] 周伟东[1] 吴刚[1] 吴登龙[1] 

机构地区：[1]同济大学附属同济医院泌尿外科,上海200065

出　　处：《中国男科学杂志》2016年第4期26-29,共4页Chinese Journal of Andrology

基　　金：国家自然科学基金面上项目资助(项目编号:81370793)

摘　　要：目的探索尿道海绵体非离断尿道吻合术治疗骨盆骨折引起的后尿道狭窄(包括闭锁)的手术效果。方法本研究共19例骨盆骨折引起的后尿道狭窄患者,采用尿道海绵体非离断尿道吻合术重建尿道,以保护阴茎和尿道海绵体的血供免受损伤;随访6个月后,通过尿流率、尿道造影及夜间阴茎勃起(NPT)监测结果对手术效果进行评估。结果术后随访,1例患者拔管后出现排尿困难,行尿道内切开后好转,其余患者均排尿通畅,无狭窄复发;NPT监测结果显示勃起功能术前、术后无明显差异。结论对于适合的后尿道狭窄患者,应用尿道海绵体非离断尿道吻合术效果确切,能够在一定程度上减少手术因素对于阴茎和尿道海绵体血供的损伤。Objective To explore the effect of non-transecting anastomotic urethroplasty for the treatment of posterior urethral stricture （ including blocking） caused by pelvic fractures. Methods A total of 19 cases of posterior urethral stricture patients caused by pelvic fracture were enrolled in the study. Non-transecting anastomotic urethroplasty was applied to treat the posterior urethral stricture in order to protect the penis and urethral sponge body blood supply . After 6 months of follow-up, the effect of operation was evaluated by the urine flow rate, urethrography and NPT results. Results One patient had difficulty in urination after the removal of catheter, and the other patients urinated smoothly after operation and had no recurrence of stenosis. NPT results showed that the erectile function was slightly decreased, but there was no statistical difference. Conclusion Non-transecting anastomotic urethroplasty is an effective operation method for posterior urethra reconstruction, and it can reduce the occurrence of blood supply damage of the penis and urethral sponge body.

关 键 词：尿道狭窄 修复外科手术 骨盆骨折 

分 类 号：R699.6[医药卫生—泌尿科学] R683.3[医药卫生—外科学]