尿道吻合术及口腔黏膜移植尿道成形术对尿道狭窄患者疗效及尿流动力学、排尿功能的影响  

Effects of different surgical treatments on the curative effect,urodynamics and voiding function of patients with urethral stricture

作　　者：王照[1] 赵丽云 张玲[2] 王磊[1] 徐哲 罗子靖[1] WANG Zhao;ZHAO Li-yun;ZHANG Ling;WANG Lei;XU Zhe;LUO Zi-jing(Department of Urology I,the First Hospital of Hebei Medical University,Shijiazhuang 050031;Department of Vascular Surgery,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北医科大学第一医院泌尿外一科,河北石家庄050031 [2]河北医科大学第二医院血管外科,河北石家庄050000

出　　处：《川北医学院学报》2022年第7期866-870,共5页Journal of North Sichuan Medical College

基　　金：河北省卫生健康委科研基金项目(20160204)。

摘　　要：目的:探讨不同手术方式治疗对尿道狭窄患者疗效及尿流动力学及排尿功能的影响。方法:选取108例尿道狭窄患者为研究对象,根据治疗方式不同分为对照组和观察组,每组各54例。对照组采用尿道吻合术进行治疗;观察组采用口腔黏膜移植尿道成形术进行治疗。比较两组患者疗效、尿流动力学指标、排尿功能及并发症发生情况,分析患者相关指标与术后最大尿流率的相关性。结果:两组患者术后治疗有效率均>90%;观察组患者手术时间、术中出血量及住院时间低于对照组(P<0.05)。术后,观察组患者残余尿量(RUV)低于对照组(P<0.05);最大尿流率(Qmax)高于对照组(P<0.05);两组患者术后并发症发生情况、国际前列腺症状评分表(IPSS)评分比较,差异无统计学意义(P>0.05);观察组患者生活质量评价表(QOL)评分低于对照组(P<0.05)。相关性分析显示,两组患者尿道狭窄长度及术中出血量与术后Qmax呈负相关(对照组:r值=-0.821、-0.855,P<0.05;观察组:r值=-0.857、-0.839,P<0.05);最优线性方程y_(对照组)=22.395-0.069X_(1)-0.552X_(2),y_(观察组)=30.93-0.823X_(1)-0.299X_(2)。结论:尿道吻合和口腔黏膜移植尿道成形术均可有效治疗尿道狭窄,但口腔黏膜移植尿道成形术患者手术时间、术中出血量、尿流动力学指标及排尿功能均优于尿道吻合术。Objective:To explore the effects of different surgical treatments on the curative effect,urodynamics and voiding function of patients with urethral stricture.Methods:108 patients with urethral stricture were selected as the research objects,and divided into the control group and the observation group according to different treatment methods,with 54 cases in each group.The control group was treated with urethral anastomosis,and the observation group was treated with oral mucosal transplantation and urethroplasty.The efficacy,urodynamics,urinary function and complications of the two groups were compared,and the correlation between the related indexes and the maximum postoperative uroflowrate was analyzed.Results:The effective rate of postoperative treatment in both groups was greater than 90%.The operation time,intraoperative blood loss and hospital stay in the observation group were lower than those in the control group(P<0.05).After the operation,the residual urine volume(RUV)of the observation group was lower than that of the control group,and the maximum flow rate(Qmax)was higher than that of the control group(P<0.05).There was no significant difference in the incidence of postoperative complications and international prostate symptom score(IPSS)score between the two groups(P>0.05).The quality of life assessment(QOL)score of the observation group was lower than that of the control group(P<0.05).According to Pearson correlation analysis,the length of stenosis and intraoperative blood loss of the two groups were correlated with postoperative Qmax.The r of the control group were-0.821 and-0.855,and the observation group were-0.857 and-0.839,and the P values were all<0.05.Establish the optimal linear equation y_(control group)=22.395-0.069X_(1)-0.552X_(2),y_(observation group)=30.93-0.823X_(1)-0.299X_(2).Conclusion:Both surgical methods can treat urethral stenosis,but the surgical time,intraoperative bleeding volume,urodynamic indicators and urinary function of patients undergoing oral mucosal transplantation ureth

关 键 词：尿道狭窄 尿道吻合术 口腔黏膜移植尿道成形术 尿流动力学 排尿功能 疗效 

分 类 号：R699[医药卫生—泌尿科学]