摘要
目的:探讨青海地区应用舌黏膜代尿道在复杂性前尿道狭窄中的临床应用价值,以获得一种较理想的治疗复杂性前尿道狭窄的手术方法。方法:收集2018年1月—2020年1月我院泌尿外科应用舌黏膜代尿道治疗28例复杂性前尿道狭窄男性患者的临床资料,并进行临床随访。随访后,复查尿道造影通畅的23例患者列为手术成功组,3例尿道狭窄及2例尿瘘患者列为失败组。分析两组患者年龄、民族、手术时间、尿道狭窄部位与长度、术前手术次数、舌黏膜切取长度及宽度与术后狭窄复发及尿道瘘发生情况。结果:28例患者术后至少随访6个月,其中正常排尿23例(82.1%),该23例患者复查尿道造影通畅,最大尿流率(16.6~47.8)m L/s,平均尿流率(25.3±7.6)m L/s。术后3例患者再次出现尿道狭窄,2例经过尿道扩张等治疗后排尿通畅,另1例失访。术后2例患者出现尿道瘘,其中1例经过再次修补术后排尿通畅,另1例尿道瘘患者未继续治疗。术后未出现尿失禁患者。28例患者中术后出现伸舌受限者5例,该5例患者经过随访6个月后症状均消失。根据术后成功组和失败组行舌黏膜移植物疗效相关单因素分析结果显示舌黏膜移植材料在(1.2~1.5)cm内取材越宽,术后成功率越高(P<0.05),而尿道狭窄原因、术前手术次数、狭窄部位、民族、年龄、狭窄长度、舌黏膜切取长度、手术时间均不影响手术成功率(P>0.05)。结论:舌黏膜移植物在(1.2~1.5)cm内移植材料的宽度越宽则手术成功率越高,舌黏膜代尿道在治疗复杂性前尿道狭窄中成功率较高,舌黏膜是一种安全、有效的治疗复杂性前尿道狭窄的移植物,为青海地区治疗复杂性前尿道狭窄提供了一种有效的手术方案。
Objective:This paper is aimed to explore the value and complications of the application of tongue mucosa in complex anterior urethral strictures in Qing Hai province to explore an ideal method for the treatment of anterior urethral stricture. Methods:Clinical data of 28 patients with complicated anterior urethral stricture treated with tongue mucosa were collected from Qinghai Provincial People’s Hospital from January 2018 to January 2020. The age,ethnic,the operation time,location and length of urethral stricture,the number of preoperative operation,indwelling time of stent,length and width of lingual mucosa resection and postoperative stenosis were analyzed by univariate analysis. Results:28 patients were followed up for at least 6 months.23 patients(82.1%)had normal micturition.There were 5 cases of urethral strictures and related complications,including 2 case of urethral fistula.One of them after urethral repair,his urination was unobstructed.Another case of urethral fistula did not require further treatment.Two cases of anastomotic stenosis were treated with multiple urethral dilatation to smooth urination.Another case of anastomotic stenosis was losted.Five patients with restricted tongue extension after lingual mucosal transplantation were included. All of them had remission after 6 months.According to the successful group(n =23)and failure group(n =5)line of tongue mucosa grafts curative effect of analysis,the results showed that Lingual mucosal graft materials were more widely used in(1.2~1.5)cm,and the incidence of postoperative complications was lower(P < 0.05).and the reason of urethral stricture,the number of preoperative operation,the site of urethral stricture,ethnic,age,length of urethral stricture,tongue mucosa cut length,and operating time will not affect the success rate of operation(P > 0.05).Conclusion:Lingual mucosal graft materials were more widely used in(1.2~1.5)cm,and the incidence of postoperative complications was lower.It is a suitable graft material to treat complicated anterior u
作者
王东朝
乜国雁
章晓东
杜杨洋
靳锐
龚伟建
周炳鹏
朱付勇
易文发
Wang Dongzhao;Nie Guoyan;Zhang Xiaodong;Du Yangyang;Jin Rui;Gong Weijian;Zhou Binpeng;Zhu Fuyong;Yi Wenfa(Urology Department,The People's Hospital of Qinghai,810007)
出处
《青海医药杂志》
CAS
2021年第5期1-5,共5页
Qinghai Medical Journal
基金
2019年青海省卫生健康系统指导性计划课题(课题编号:2019—wjzdx—25)。
