骨盆骨折后尿道憩室伴巨大结石1例并文献复习  

Giant calculi in urethral diverticulum after pelvic fracture:a case report and literature review

作　　者：彭晓文 李树林 王晓彬 肖运政 张贤生[2] Peng Xiaowen;Li Shulin;Wang Xiaobin;Xiao Yunzheng;Zhang Xiansheng(Department of Urology,Southern University of Science and Technology Hospital,Shenzhen 518055,Guangdong,China;Department of Urology,The First Affiliated Hospital of Anhui Medical University,Hefei 230032,Anhui,China)

机构地区：[1]南方科技大学医院泌尿外科,广东深圳518055 [2]安徽医科大学第一附属医院泌尿外科,安徽合肥230032

出　　处：《中国男科学杂志》2024年第6期84-87,共4页Chinese Journal of Andrology

摘　　要：目的探讨骨盆骨折后尿道憩室结石的诊疗策略。方法分析2023年8月南方科技大学医院收治的1例骨盆骨折后尿道憩室巨大前尿道结石患者的临床资料、诊疗过程及随访情况,结合文献复习并探讨其诊疗策略。结果该患者急诊以“急性尿潴留;前尿道狭窄”入院,行经尿道输尿管镜检查术,术中可见巨大前尿道结石,抗炎治疗后二期行经尿道肾镜下尿道结石钬激光碎石取石术,术后6个月电话随访,患者可正常排尿、射精,无其他不良并发症。结论对于急性尿潴留的患者,必须进行积极体检、泌尿系统彩超、盆腔DR和尿路CT。术前积极抗感染治疗、通畅排尿能有效避免脓毒血症的发生,肾镜可用于碎石手术,碎石通道建立可使用腹腔镜的Trocar,能有效提高碎石效率。Objective To explore the diagnosis and treatment strategy for urethral diverticulum stones after pelvic fracture.Methods Clinical data,diagnosis and treatment process and follow-up of a patient with large anterior urethral stone after pelvic fracture,who admitted to Southern University of Science and Technology Hospital in August 2023,were analyzed,and the diagnosis and treatment strategy was discussed based on literature review.Results The patient was hospitalized as an emergency patient with“acute urinary retention;anterior urethral stricture”.During transurethral ureteroscopy,huge anterior urethral stones were seen during the operation.After anti-inflammatory treatment,a second stage transurethral nephroscopic holmium laser lithotripsy was performed.The patient was followed up by telephone 6 months after the operation.The patient could urinate and ejaculate normally without other adverse complications.Conclusion For patients with acute urinary retention,active physical examination,urinary system color ultrasound,pelvic DR and urinary tract CT must be performed.Active anti-infection treatment and smooth urination before surgery can effectively avoid the occurrence of sepsis.Nephroscopy can be used for surgical lithotripsy,and laparoscopic Trocar can be used to establish lithotripsy channels,which can effectively improve the efficiency of lithotripsy.

关 键 词：尿路结石 病例报告 尿道结石碎石术 碎石通道 

分 类 号：R691.4[医药卫生—泌尿科学]