摘要
目的:探讨输尿管镜经尿道和经皮耻骨上膀胱微创技术治疗尿道损伤疗效。方法:将66例闭合性尿道损伤患者按手术方式不同使用随机数字表法分为观察组(经尿道和经皮耻骨上输尿管镜尿道会师术)和对照组(开放手术或经会阴尿道吻合术)。对比两组术中出血量、手术用时、住院时间、最大尿流量,统计并发症发生率及治疗总有效率。结果:与对照组相比,观察组住院时间、手术用时更短,术中出血量更少,术后最大尿流率达(22.30±1.76)m L/s,与对照组的(17.54±2.33)m L/s差异明显;观察组并发症发生率(12.12%)低于对照组(51.52%),观察组无勃起障碍发生;治疗总有效率(96.97%)高于对照组(81.82%)。P均<0.05。结论:与传统手术比较,输尿管镜经尿道和经皮耻骨上膀胱微创技术治疗尿道损伤具有以下优势:(1)术野好,操作精确,无需解剖,有效缩短手术时间;(2)创伤小,不伤及支配勃起功能的神经和血管,术后无勃起障碍,尿道狭窄发生少,并发症发生率明显降低;(3)不促进康复进程,缩短住院时间,提高术后最大尿流量。
Objectives： To investigate the effect of urethral ureteroscopy and percutaneous suprapubic ureteroscopy minimally invasive treatment on urethra damage. Methods： 66 closed urethral injury patients were random-ly divided into two groups according to different surgical procedures,observation group（ urethral and suprapubic percutaneous ureteroscopy） and control group（ open surgery or perineal urethral anastomosis）. Blood loss,surgical time,hospital stay,maximum urine flow,statistical incidence of complications and total efficiency of two groups were compared. Results： Compared with control group,the observation group had shorter hospital stay,less operation time and less blood loss. The postoperative maximum flow of observation group was（ 22. 30 ± 1. 76） m L / s,and it was（ 17. 54 ± 2. 33） m L / s in control group,with significant difference; complication rate of observation group（ 12. 12%） was lower than that of control group（ 51. 52%）. No erectile dysfunction occurred in observation group;total effective rate of observation group（ 96. 97%） was higher than that of control group（ 81. 82%）,P〈0. 05.Conclusion： Compared with traditional surgery,transurethral ureteroscopy and percutaneous suprapubic minimally invasive treatment of urethral injury has the following advantages： 1） good surgical field,accurate operation,without dissection and short operation time; 2） small wound,no harm to nerves and blood vessels dominating erectile function,no postoperative erectile dysfunction and less complication rate; 3） fast rehabilitation process,short hospital stay and increase of postoperative maximum urine flow.
作者
南锡浩
田河
邸彦橙
安瑞华
NAN Xihao TIAN He DI Yancheng AN Ruihua(Department of Urology, The First Hospital Affiliated to Harbin Medical University, Harbin 150001, Heilongjiang, China)
出处
《中国性科学》
2016年第12期38-41,共4页
Chinese Journal of Human Sexuality
关键词
尿道损伤
输尿管镜
尿道会师
尿道狭窄
Urethral injury
Ureteroscopy
Urethral realignment
Urethral stricture
