男性闭合性尿道损伤国内外急诊处理方法的比较  

Comparison of the emergency treatment of male urethral trauma between China and other countries

作　　者：张羽萌 傅强[2] ZHANG Yumeng;FU Qiang(tDepartment of Urology, Qilu Second Hospital of Shandong University, Jinan, 250033, Chi- n;Department of Urology, Sixth People＂ s Hospital Affiliated to Shanghai Jiao Tong Univer- sity)

机构地区：[1]山东大学齐鲁第二医院泌尿外科,济南250033 [2]上海交通大学附属第六人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2018年第3期172-176,共5页Journal of Clinical Urology

摘　　要：目的:总结国内对男性闭合性尿道损伤的各种急诊处理方式,分析其疗效,并与国外相关文献进行比较。方法:在多种数据库内搜索了2000~2016年内关于此主题的国内及国外文献。167篇文献入选本研究,中文文献144篇,外文文献23篇。所有文献均为回顾性研究。我们分析了各种处理方法(包括开放会师、内镜会师、Ⅰ期修复)的效果及并发症,并将各种治疗方法在国内与国外的疗效进行对比。结果:国内医师较少应用尿道造影作为诊断依据。对于后尿道会师术,国外与国内文献报道的成功率相近(51.5%vs.57.0%);但对于前尿道会师术,不同文献报道的成功率相差很大,从0~80%不等。国内医师认为前尿道Ⅰ期修复手术成功率高(总体>85%),目前仍有较多应用,但国外已基本放弃此术式。结论:国内对于男性尿道损伤的急诊处理与国外仍有较多不同之处,部分做法可以继续推广,但也有些做法应该被纠正。Objective： To compare the outcome of different emergency treatments between China and other countries in treating blunt urethral trauma. Method： We searched Chinese and English literature about this topic from 2000 to 2016. Totally 167 studies were included, including 144 Chinese articles and 23 English articles. All studies were retrospective in nature. We analyzed surgical methods including open realignment, endoscopic re- alignment and primary repair. We compared the success rate and complications of each method. Result： Realign- ment of posterior urethra had similar success rate in English and Chinese literature （51.5% vs. 57.0 % respective- ly）, but the outcome of realignment of anterior urethra was greatly variable （ranged from 0 to 80%）. While long abandoned in western countries, primary repair of anterior urethra is still an option in China, and has high success rate （〉85% overall）. Conclusion： Treatment of emergency urethral injury in China has many differences compared with western countries. Some practices should be corrected and some may be worthy promoting.

关 键 词：尿道损伤 尿道会师 I期尿道修复 

分 类 号：R699.6[医药卫生—泌尿科学]