尿道拖入联合尿道吻合术对男性创伤后尿道狭窄患者尿流动力学、性功能及生活质量的影响  

Effects of urethral pull-in combined with urethral anastomosis on urodynamics,sexual function and quality of life in male patients with urethral stricture after trauma

作　　者：文红壮[1] 高社全[1] WEN Hong-zhuang;GAO She-quan(First Department of Urology Surgery,Handan Central Hospital of Hebei Province,Handan,Hebei 056001,China)

机构地区：[1]邯郸市中心医院泌尿外一科,河北邯郸056001

出　　处：《创伤外科杂志》2020年第7期550-554,共5页Journal of Traumatic Surgery

基　　金：河北省科技支撑计划项目(16277772D)。

摘　　要：目的探讨尿道拖入术联合尿道吻合术对男性创伤后尿道狭窄患者尿流动力学、性功能及生活质量的影响。方法回顾性分析2015年3月—2019年3月河北省邯郸市中心医院泌尿外一科收治的79例创伤后尿道狭窄男性患者的临床资料,依据术式不同分为扩张组(n=34,骨盆骨折后致尿道狭窄,实施腔镜尿道狭窄扩张术)和吻合组(n=45,骨盆骨折后致尿道狭窄,实施尿道拖入及尿道吻合术)。比较两组患者术中出血量、手术时间、术后排气时间及住院时间以及术前和术后6个月的残余尿量(RUV)、最大尿流率(Qmax)、国际勃起功能评分问卷(IIEF-5)评分,夜间阴茎勃起的次数、时间和强度,生活质量综合评定问卷-74(GQOLI-74)评分。结果吻合组患者的术中出血量、手术时间、术后排气时间及住院时间分别为(148.41±37.64)mL、(197.3±25.6)min、(15.2±3.7)h、(10.3±3.2)d,多于扩张组的(35.27±11.53)mL、(60.2±13.5)min、(11.5±3.3)h、(4.8±2.6)d(P<0.05)。术前两组患者的Qmax、RUV比较差异无统计学意义(P>0.05);术后6个月吻合组患者的Qmax为(14.23±3.27)mL/s,大于扩张组(11.18±2.86)mL/s,RUV为(13.17±4.23)mL,少于扩张组(19.46±4.87)mL(P<0.05)。术前两组患者的性功能指标比较差异无统计学意义(P>0.05);术后6个月吻合组夜间阴茎勃起的次数、时间、强度、IIEF-5评分分别为(5.8±0.9)次、(8.4±1.8)min、(78.25±7.31)mmHg、(12.3±2.5)分,高于扩张组的(4.5±0.8)次、(6.3±1.3)min、(72.24±8.53)mmHg、(9.4±2.8)分(P<0.05);术后6个月吻合组GQOLI-74评分的物质生活、社会功能、躯体功能、心理功能评分分别为(69.4±7.8)分、(72.4±9.3)分、(64.2±8.8)分、(62.2±9.7)分,高于扩张组的(62.5±8.3)分、(59.1±8.5)分、(53.2±8.3)分、(56.8±9.1)分(P<0.05)。结论尿道拖入术联合尿道吻合术治疗男性创伤后尿道狭窄,虽然手术创伤较大,术后恢复慢,但相较于腔镜尿道狭窄扩张术可更好地改善患者尿�Objective To investigate the effects of urethral pull-in combined with urethral anastomosis on urodynamics,sexual function and quality of life in male patients with urethral stricture after trauma.Methods A total of 79 male patients with post-traumatic urethral stricture who were treated in our hospital from Mar.2015 to Mar.2019 were retrospectively selected as the research objects.According to different surgical methods,the patients were divided into the dilatation group(n=34,for endoscopic urethral stricture dilatation)and the anastomosis group(n=45,for urethral pull and urethral anastomosis).The surgical-related indicators,residual urine volume(RUV),maximum urinary flow rate(Qmax),international erectile function score questionnaire(IIEF-5)score,and number of nocturnal penile erection time and intensity,quality of life questionnaire-74(GQOLI-74)score were compared between the two groups.Results In the anastomosis group,the intraoperative blood loss,the operative time,the postoperative exhaust time and the length of stay were(148.41±37.64)mL,(197.23±25.64)min,(15.24±3.72)h,(10.25±3.18)d,respectively,which were more than(35.27±11.53)mL,(60.14±13.52)min,(11.48±3.25)h and(4.84±2.56)d in the dilatation group(P<0.05).Six months after operation,Qmax(14.23±3.27)mL/s in the anastomosis group was greater than that in the dilatation group(11.18±2.86)mL/s,RUV(13.17±4.23)mL was less than that in the dilatation group(19.46±4.87)mL(P<0.05).The number of nocturnal penile erection,the erection time,the erection intensity,and the IIEF-5 score in the anastomosis group were(5.75±0.92)times,(8.43±1.74)min,(78.25±7.31)mmHg,(12.34±2.44)points,respectively,which were higher than(4.47±0.87)times,(6.25±1.34)min,(72.24±8.53)mmHg,(9.42±2.76)points in the dilatation group(P<0.05).Six months after operation,the scores of common life,social function,physical function and psychological function of GQOLI-74 score in the anastomosis group were(69.39±7.84)points,(72.35±9.38)points,(64.17±8.77)points,(62.17±9.75)points,res

关 键 词：创伤后尿道狭窄 拖入术 吻合术 尿流动力学 

分 类 号：R695[医药卫生—泌尿科学]