舌黏膜和颊黏膜在口腔黏膜尿道成形术中的比较  

Lingual versus buccal mucosa graft in anterior urethroplasty

作　　者：翟建坡[1] 刘宁[1] 王海[1] 黄广林[1] 满立波[1] ZHAI Jianpo;LIU Ning;WANG Hai;HUANG Guanglin;MAN Libo(Department of Urology,Beijing Jishuitan Hospital,Beijing 100096,China)

机构地区：[1]北京积水潭医院泌尿外科,北京100096

出　　处：《实用医学杂志》2019年第5期769-771,共3页The Journal of Practical Medicine

基　　金：北京市医院管理局"青苗"计划专项经费资助(编号:QML20170405);北京积水潭医院"学科新星"计划专项经费资助(编号:XKXX201616)

摘　　要：目的对比舌黏膜和颊黏膜在口腔黏膜尿道成形术的疗效及其并发症。方法回顾性分析北京积水潭医院泌尿外科2013年7月-2018年7月间收治的尿道成形术的患者共计138例。其中颊黏膜尿道成形术患者88例,舌黏膜尿道成形术患者50例。收集患者的年龄,尿道狭窄的病因,尿道狭窄的部位及长度。统计患者术后最大尿流率,以及尿瘘,尿道感染和尿道狭窄等并发症发生情况,同时统计其术后口腔疼痛,出血,发音困难和味觉异常等口腔部位并发症发生情况。结果尿道成形术后患者的最大尿流率在颊黏膜组为15.1 mL/s,在舌黏膜组为14.9 mL/s。尿道成形术后尿道感染,尿道狭窄和尿瘘的发生率在颊黏膜组分别6.8%,5.7%和1.1%,在舌黏膜组中分别为6%,8%和2%。尿道成形术后第1周随访时,颊黏膜组有35.2%的患者存在发音困难,而舌黏膜组有66%的患者有发音困难(P=0.001)。颊黏膜组有10.2%的患者存在味觉异常,而舌黏膜组中的比例是30%(P=0.005)。结论舌黏膜可作为尿道成形术的尿道替代材料应用于临床,但取材部位有较高的短期并发症发生率。Objective To compare the efficacy and complications of buccal mucosa and lingual mucosa graft in anterior urethroplasty. Methods A retrospective analysis of 138 cases of urethroplasty admitted to the Department of Urology,B eijing Jishuitan Hospital from July 2013 to July 2018. Among them,88 patients had buccal mucosa urethroplasty and 50 patients had lingual mucosal urethroplasty. The age of the patient,the cause of urethral stricture,and the location and length of the urethral stricture were collected. The maximum postoperative urinary flow rate(Qmax), as well as complications such as urinary fistula,urinary tract infection and urethral stricture were counted. The postoperative oral pain,bleeding,speaking disorders and dysgeusia were counted simultaneously. Results Qmax after the urethroplasty was 15.1 mL/s in the buccal mucosa group and 14.9 mL/s in the lingual mucosa group. The incidence of post operative urethral infection,urethral stricture and fistula were 6.8%,5.7% and 1.1% in the buccal mucosa group and 6%,8% and 2% in the lingual mucosa group,respectively. At the first week of follow up,speaking disorder was occurred in 35.2% of patients in the buccal mucosa group and 66% of patients in the lingual mucosa group(P = 0.001). The dysgeusia occurred in 10.2% of patients in the buccal mucosa and 30% in the lingual mucosa group(P = 0.005). Conclusions Lingual mucosa graft is a good urethral substitute for urethroplasty,with higher incidence of short term donor site complications.

关 键 词：尿道成形术 舌黏膜 颊黏膜 尿道狭窄 

分 类 号：R699[医药卫生—泌尿科学]