B超定位经皮膀胱穿刺联合输尿管镜下尿道会师术治疗尿道损伤的临床应用  

Clinical Application of B-ultrasound Positioning Percutaneous Bladder Puncture Combined with Ureteroscopy Urethral Realignment in the Treatment of Urethral Injury

作　　者：黄金球 熊思清[1] 龙大治 傅恩君[1] 刘彧 HUANG Jinqiu;XIONG Siqing;LONG Dazhi;FU Enjun;LIU Yu(Ji’an Central People’s Hospital,Jiangxi Province,Ji’an 343000,China;不详)

机构地区：[1]江西省吉安市中心人民医院,江西吉安343000

出　　处：《中国医学创新》2022年第28期28-31,共4页Medical Innovation of China

基　　金：吉安市指导性科技计划项目(吉市科计字[2019]8号(10))。

摘　　要：目的:探讨尿道损伤治疗中B超定位经皮膀胱穿刺联合输尿管镜下尿道会师术的效果。方法:选取2019年2月-2021年12月吉安市中心人民医院尿道损伤患者68例,依据手术方法分为开放性尿道吻合术组(尿道吻合术组)、B超定位经皮膀胱穿刺联合输尿管镜下尿道会师术组(尿道会师术组),各34例。统计分析两组围术期指标、最大尿流率、残余尿量、临床疗效、术后并发症发生情况。结果:尿道会师术组术中出血量少于尿道吻合术组(t=39.008,P<0.05),手术时间短于尿道吻合术组(t=16.282,P<0.05),住院时间短于尿道吻合术组(t=13.199,P<0.05)。术后,尿道会师术组残余尿量少于尿道吻合术组(P<0.05),最大尿流率高于尿道吻合术组(P<0.05)。尿道会师术组患者的总有效率91.18%(31/34),高于尿道吻合术组的61.76%(21/34)(χ^(2)=8.173,P<0.05)。尿道会师术组患者的术后并发症发生率5.88%(2/34),低于尿道吻合术组的50.00%(17/34)(χ^(2)=16.434,P<0.05)。结论:尿道损伤治疗中,与开放性尿道吻合术相比,B超定位经皮膀胱穿刺联合输尿管镜下尿道会师术的效果较好。Objective:To explore the effect of B-ultrasound positioning percutaneous bladder puncture combined with ureteroscopy urethral realignment in the treatment of urethral injury.Method:From February 2019 to December 2021,68 cases with urethral injury in Ji’an Central People’s Hospital were selected,they were divided into open urethral anastomosis group(urethral anastomosis group),B ultrasonic positioning percutaneous bladder puncture ureteroscopy urethral realignment group(urethral realignment group)according to the operation method,34 cases in each group.Perioperative indicators,maximum urine flow rate,residual urine volume,clinical efficacy and incidences of postoperative complications in two groups were statistically analyzed.Result:The amount of intraoperative blood loss in the urethral realignment group was less than that in the urethral anastomosis group(t=39.008,P<0.05),the operation time was shorter than that in urethral anastomosis group(t=16.282,P<0.05),and the hospital stay was shorter than that in urethral anastomosis group(t=13.199,P<0.05).After operation,the maximum urine flow rate in the urethral realignment group was higher than that in the urethral anastomosis group(P<0.05),and the residual urine volume was lower than that in urethral anastomosis group(P<0.05).The total effective rate in urethral realignment group was 91.18%(31/34),which compared with 61.76%(21/34)in the urethral anastomosis group was higher(χ~2=8.173,P<0.05).The incidence of postoperative complications in urethral realignment group was 5.88%(2/34),which was lower than 50.00%(17/34)in urethral anastomosis group(χ~2=16.434,P<0.05).Conclusion:In the treatment of urethral injury,the clinical effect of B-ultrasound localization percutaneous bladder puncture combined with ureteroscopy urethral realignment is better than that of open urethral anastomosis.

关 键 词：尿道损伤 B超定位 经皮膀胱穿刺 输尿管镜 尿道会师术 开放性尿道吻合术 

分 类 号：R699[医药卫生—泌尿科学]