对比分析内镜下、开放性尿道会师术对尿道损伤患者尿流动力学、性功能及并发症的影响  

Comparative analysis of the effects of endoscopic and open urethral realignment on urodynamics,sexual function and complications in patients with urethral injury

作　　者：杜盛庭 余明主[1] Du Shengting;Yu Mingzhu(The 908th Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army,Nanchang 330000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院,南昌330000

出　　处：《广西医科大学学报》2022年第10期1617-1621,共5页Journal of Guangxi Medical University

基　　金：南京军区医学科技创新课题(No.11MA064)。

摘　　要：目的:对比分析内镜下、开放性尿道会师术对尿道损伤(UI)患者尿流动力学、性功能及并发症的影响。方法:收集我院75例UI患者的临床资料,开展回顾性研究。按治疗术式不同分为内镜组(n=38)、开放组(n=37)。两组均行尿道会师术治疗,开放组行开放性手术,内镜组行内镜下手术。比较两组疗效、手术有关情况、并发症情况及术后6 h、12 h、24 h视觉模拟评分量表(VAS)评分,并比较两组尿流动力学、性功能变化情况。结果:内镜组总有效率(97.37%)高于开放组(78.38%)(P<0.05);与开放组比较,内镜组术中出血量明显减少,手术时间、住院时间均明显缩短(P<0.05);内镜组术后6 h、12 h、24 h的VAS评分均低于开放组(P<0.05);内镜组术后3个月最大尿流率(Qmax)高于开放组,残余尿量(RUV)低于开放组(P<0.05);术后3个月、6个月夜间阴茎勃起时间、次数均高于开放组(P<0.05);内镜组并发症发生率(7.89%)低于开放组(29.73%)(P<0.05)。结论:与开放性尿道会师术比较,采用内镜下尿道会师术治疗UI,能更好改善患者尿流动力学,且能减轻对性功能的损害,降低术后并发症发生率,临床疗效更好。Objective:To compare and analyze the effects of endoscopy and open urethral realignment on the urodynamics,sexual function and complications in patients with urethral injury(UI).Methods:The clinical data of 75 patients with UI in our hospital were collected and a retrospective study was conducted.The subjects were divided into an endoscopic group(n=38)and an open group(n=37)according to the treatment procedure.Both groups were treated with urethral realignment,with open surgery in the open group and endoscopic surgery in the endoscopic group.The efficacy,procedure-related conditions,complications and visual analog scale(VAS)scores at 6 h,12 h and 24 h after surgery were compared between the two groups,and the changes in urodynamics and sexual function were also compared between the two groups.Results:The total effective rate was higher in the endoscopic group(97.37%)than in the open group(78.38%)(P<0.05);compared with the open group,the intraoperative bleeding was significantly reduced in the endoscopic group,and the operative time and hospital stay were significantly shorter(P<0.05);the VAS scores at 6 h,12 h and 24 h after surgery were lower in the endoscopic group than in the open group(P<0.05);3 months after surgery in the endoscopic group,the maximum urine flow rate(Qmax)was higher in the endoscopic group than in the open group,and the residual urine volume(RUV)was lower than in the open group(P<0.05);the duration and number of nocturnal penile erections at 3and 6 months after surgery were higher than in the open group(P<0.05);the complication rate was lower in the endoscopic group(7.89%)than in the open group(29.73%)(P<0.05).Conclusion:Compared with open urethral realignment,endoscopic urethral realignment can better improve the urodynamics of UI patients,reduce the damage to their sexual function,reduce the incidence of postoperative complications,and has superior clinical efficacy.

关 键 词：尿道损伤 尿道会师术 内镜 尿流动力学 性功能 

分 类 号：R695[医药卫生—泌尿科学]