尿道骑跨伤急诊手术治疗方法探讨(附29例报告)  

Emergency surgical treatment of urethral straddle injury (report of 29 cases)

作　　者：李旵灿 Li Chancan(Department of Urology,Anhui No.2 Provincial People's Hospital,Hefei 230041,China)

机构地区：[1]安徽省第二人民医院泌尿外科,合肥230041

出　　处：《国际泌尿系统杂志》2022年第3期514-517,共4页International Journal of Urology and Nephrology

摘　　要：目的探讨急诊手术治疗尿道骑跨伤的临床疗效。方法回顾性分析2015年2月至2019年9月于本院收治的29例因尿道骑跨伤导致尿道部分断裂患者的临床资料。其中15例患者行开放性手术(开放手术组),另外14例患者有13例行内镜下尿道会师术,1例在外院行膀胱造瘘2周后,再转本院行内镜下尿道会师术(尿道会师组)。术后常规行尿道扩张4~6次,随访1年。对比分析两种术式的手术时间、术中出血量、术后住院时间及临床疗效。结果尿道会师组患者的手术时间、术中失血量及住院时间等指标均明显优于开放手术组(均P<0.01)。尿道会师组的术后尿道狭窄发生率明显高于开放手术组(66.67%vs.11.11%,P<0.01)。两组患者术后均无明显勃起障碍及尿失禁发生。结论与开放手术相比,内镜下尿道会师术治疗尿道骑跨伤导致尿道部分断裂患者创伤小,手术时间短,恢复快且疗效相同。尿道完全断裂患者尿道会师术术后尿道狭窄发生率高,早期实施一期尿道吻合术,进行彻底清创,不仅可减轻术后尿道瘢痕狭窄,而且还能有效恢复尿道的连续性,术后尿道狭窄发生率低。Objective To investigate the effect of emergency operation on urethral straddle injury.Methods From February 2015 to September 2019,29 cases of partial urethral rupture due to urethral riding injury were retrospectively analyzed.Among the 29 patients,15 patients underwent open surgery(open surgery group),13 patients underwent endoscopic urethral realignment,and 1 patient was transferred to our hospital for endoscopic urethral realignment after 2 weeks of cystostomy(urethral meeting group).followed up for 1 year.The operation time,intraoperative blood loss,postoperative hospital stay and clinical efficacy of the two methods were compared.Results The indexes of operation time,intraoperative blood loss and hospital stay in urethral meeting group were significantly better than those in open surgery group(all P<0.01).The incidence of postoperative urethral stricture in the urethral junction group was significantly higher than that in the open surgery group(66.67%vs.11.11%,P<0.01).No significant erectile dysfunction and urinary incontinence occurred in two groups.Conclusions Compared with open surgery,endoscopic urethral reunion therapy for patients with partial urethral rupture caused by urethral riding injury has less trauma,shorter operation time,quicker recovery and the same efficacy.The incidence of urethral stricture after urethral realignment in patients with complete urethral rupture is high.Early implementation of one-stage urethral anastomosis and thorough debridement can not only reduce the postoperative urethral scar stricture,but also effectively restore the continuity of the urethra.The incidence of postoperative urethral stricture is low.

关 键 词：尿道 骑跨伤 尿道会师术 

分 类 号：R699.6[医药卫生—泌尿科学]