尿道球囊扩张术与探条扩张术治疗男性尿道狭窄的疗效比较  

Comparison of the efficacy between balloon dilatation and probe strip dilatation for male patients with urethral stricture

作　　者：郭振可 吉星 徐纯如 朱振鹏 李晓宇[1] 冷汶远 林健[1] Guo Zhenke;Ji Xing;Xu Chunru;Zhu Zhenpeng;Li Xiaoyu;Leng Wenyuan;Lin Jian(Department of Urology,Peking University First Hospital,Institution of Urology,Peking University,Beijing Key Laboratory of Urogenital Diseases(Male)Molecular Diagnosis and Treatment Center,National Urological Cancer Center,Beijing 100034,China)

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,泌尿生殖系疾病(男)分子诊治北京市重点实验室,国家泌尿男性生殖系肿瘤研究中心,北京100034

出　　处：《泌尿外科杂志（电子版）》2024年第4期1-7,共7页Journal of Urology for Clinicians(Electronic Version)

摘　　要：目的比较尿道球囊扩张术与尿道探条扩张术治疗男性尿道狭窄的临床疗效。方法选取2017年2月至2023年9月北京大学第一医院收治的101例男性尿道狭窄患者进行回顾性分析,按照不同手术方法分为两组,55例行尿道球囊扩张术患者为球囊组,46例行尿道探条扩张术患者为探条组。通过查阅电子病历、门诊、电话随访等方式,收集患者基本信息,并对患者术后并发症和狭窄复发情况进行随访。终点事件设置为需要医疗干预的术后尿道狭窄复发,干预手段包括导尿、耻骨上膀胱造瘘、尿道腔内治疗、尿道成形术等。比较两组临床疗效及影响疗效的危险因素。结果两组年龄、身高、体质量、体质量指数、术前白蛋白、白细胞、血红蛋白、尿道狭窄部位、是否为再次手术比较,差异无统计学意义(P>0.05);球囊组术前合并尿路感染率、医源性尿道狭窄率、狭窄段长度≥2 cm比例、多发尿道狭窄率均高于探条组,差异有统计学意义(P<0.05)。两组术后并发症发生率比较(14.55%vs.30.43%),差异无统计学意义(P>0.05)。随着时间推移,两组尿道狭窄手术有效率差异呈现逐渐显著趋势,差异有统计学意义(HR=0.42,95%CI 0.20~0.87,P=0.02)。对于术前合并尿路感染的尿道狭窄患者,球囊组手术有效率更高,差异有统计学意义(HR=0.39,95%CI 0.18~0.86,P=0.02)。无论是否为医源性尿道狭窄,两种手术方法疗效相当,差异无统计学意义(P>0.05)。对于狭窄段长度<2 cm的尿道狭窄,两种手术方式疗效相当,差异无统计学意义(P>0.05);对于狭窄段长度≥2 cm的尿道狭窄,球囊组手术有效率更高,差异有统计学意义(HR=0.18,95%CI 0.06~0.54,P=0.002)。对于首次手术干预的尿道狭窄,两组疗效相当,差异无统计学意义(P>0.05);对于需再次手术干预的尿道狭窄,球囊组手术有效率更高,差异有统计学意义(HR=0.30,95%CI 0.12~0.75,P=0.01)。患者术前是否合并尿�Objective To compare the clinical efficacy of urethral balloon dilatation and probe strip dilatation for male patients with urethral stricture.Methods A total of 101 male urethral stricture patients admitted to Peking University First Hospital from February 2017 to September 2023 were retrospectively analyzed and divided into two groups according to the surgical methods,including 55 patients of the balloon group who underwent urethral balloon dilatation and 46 patients of the probe strip group who underwent urethral probe strip dilatation.The basic information of the patients was collected by checking the electronic medical records as well as outpatient or telephone follow-up,and the patients were followed up for postoperative complications and recurrence of stenosis.The endpoint event was set as postoperative urethral stricture recurrence requiring medical intervention,which included catheterization,suprapubic cystostomy,urethral endoluminal therapy and urethroplasty.The relevant data were statistically analyzed to compare the clinical efficacy of the two surgical modalities and the risk factors affecting the efficacy.Results The basic clinical data of the two groups of patients,such as age,height,body mass,body mass index,preoperative albumin,preoperative blood leukocytes,preoperative blood hemoglobin,site of urethral stenosis,and reoperation rate,were compared and analyzed,and the results showed that there was no statistical significance in the difference between the two groups(P>0.05).The preoperative combined urinary tract infection rate,medical urethral stenosis rate,the proportion of stenosis segment length≥2 cm,and multiple urethral stenosis rate of the balloon group were higher than those of the probe strip group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of postoperative complications between the two groups(14.55%vs.30.43%)(P>0.05).The difference in the surgical efficiency of urethral stricture between the two groups showed a trend o

关 键 词：尿道狭窄 尿道球囊扩张术 尿道探条扩张术 手术疗效 保护因素 

分 类 号：R695[医药卫生—泌尿科学]