筋膜扩张器联合钬激光治疗医源性短段尿道狭窄疗效观察  

Effect of fascial dilator combined with holmium laser in the treatment of iatrogenic short segment urethral stricture

作　　者：张红森[1] 郭国营[1] ZHANG Hong-sen;GUO Guo-ying(Department of Urinary Surgery,the Central Hospital of Xinxiang City,Xinxiang 453000,Henan Province,China)

机构地区：[1]新乡市中心医院泌尿外二科,河南新乡453000

出　　处：《新乡医学院学报》2018年第4期303-305,309,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨筋膜扩张器联合钬激光治疗医源性短段尿道狭窄的临床效果及安全性。方法选择2013年5月至2016年3月新乡市中心医院收治的医源性短段尿道狭窄男性患者48例,根据治疗方法将患者分为观察组(n=22)和对照组(n=26)。观察组患者给予筋膜扩张器联合钬激光治疗,对照组患者给予传统冷刀治疗。记录2组患者的手术时间、术中出血量、尿道扩张次数、国际前列腺症状量表(IPSS)评分、排泄后残留尿量(PVR)及最大尿流率(Qmax);所有患者术后随访1 a,记录术后并发症及尿道狭窄复发情况。结果 2组患者手术时间比较差异无统计学意义(P>0.05);观察组患者术中出血量、尿道扩张次数显著少于对照组(P<0.05)。2组患者术前IPSS、PVR及Qmax比较差异均无统计学意义(P>0.05);2组患者术后IPSS、PVR显著低于术前(P<0.05),Qmax显著大于术前(P<0.05);术后观察组患者Qmax显著大于对照组(P<0.05),但2组患者术后IPSS、PVR比较差异均无统计学意义(P>0.05)。观察组和对照组患者并发症发生率分别为9.09%(2/22)、38.46%(10/26),观察组患者并发症发生率显著低于对照组(χ~2=5.493,P<0.05)。术后1 a内,观察组和对照组患者尿道狭窄复发率分别为9.09%(2/22)、34.62%(9/26),观察组患者尿道狭窄复发率显著低于对照组(χ~2=4.395,P<0.05)。结论筋膜扩张器联合钬激光治疗医源性短段尿道狭窄具有术中出血量少、术后恢复好、并发症少、复发率低等优势。Objective To investigate the clinical effect and safety of fascial dilator combined with holmium laser in the treatment of iatrogenic short segment urethral stricture.Methods A total of 48 male patients with iatrogenic short segment urethral stricture treated in the Central Hospital of Xinxiang City from May 2013 to March 2016 were divided into observation group(n=22)and control group(n=26)according to the treatment method,the patients in the observation group were treated with fascia dilator combined with holmium laser,and the patients in the control group were treated with traditional cryoprobe treatment.The operation time,intraoperative bleeding volume,the times of urethral sounding,the international prostate symptom scale(IPSS)score,postvoid residual(PVR)and the maximal urinary flow rate(Q max)in the two groups were recorded.All patients were followed up for one year,and the postoperative complications and the recurrence of urethral stricture were recorded.Results There was no significant difference in the operation time between the two groups(P>0.05).The intraoperative bleeding volume and the times of urethral sounding in the observation group were significantly less than those in the control group(P<0.05).There was no significant difference in IPSS,PVR and Q max between the two groups before operation(P>0.05).The IPSS and PVR after operation were significantly lower than those before operation(P<0.05),and the Q max after operation was significantly greater than that before operation in the two groups(P<0.05).The Q max in the observation group was significantly greater than that in the control group after operation(P<0.05),but there was no significant difference in the IPSS and PVR between the two groups after operation(P>0.05).The incidence of complications in the observation group and the control group was 9.09%(2/22)and 38.46%(10/26)respectively,and the incidence of complications in the observation group was significantly lower than that in the control group(χ2=5.493,P<0.05).The recurrence rate of urethr

关 键 词：医源性尿道狭窄 筋膜扩张器 钬激光 

分 类 号：R699.6[医药卫生—泌尿科学]