摘要
目的 探讨对复杂性尿道狭窄应用耳后皮片重建尿道的可行性、手术效果及应用价值。 方法 1998年 5月～ 2 0 0 2年 9月 ,选择 17例复杂性尿道狭窄患者 ,前尿道狭窄 6例 ,后尿道狭窄 11例。切取合适大小耳后皮片 ,修整为刃厚或中厚皮片 ,彻底剔除原狭窄段尿道及瘢痕 ,行狭窄段尿道重建 ,其中二期成形术 14例 ,一期成形术 3例。术后均常规留置尿道支架和耻骨上膀胱造瘘管 ,给予抗生素冲洗尿道。 结果 术后均获 12～ 2 4个月随访 ,其中术后 4～ 5周排尿通畅 15例 ,尿道造影结果良好 ,测定最大尿流率 14～ 32 ml/s,手术成功率为 88.2 %。术后 6个月内出现并发症 2例 ,1例因感染致吻合口瘘 ,经修补治愈 ;1例后尿道严重再狭窄 ,经使用对侧耳后皮片再次移植重建成功。术后 6个月后 ,前尿道轻度再狭窄 1例 ,后尿道轻度再狭窄 2例 ,经尿道扩张后均获满意效果。 结论 耳后皮片可作为一种理想的、效果满意的尿道替代材料修复重建复杂性尿道狭窄 ,值得推广。
Objective To explore and describe the clinical feasibility and value of reconstruction of complex urethral stricture with free postauricular graft. Methods Urethroplasties with free postauricular grafts were performed in 17 patients with complex urethral strictures, including 6 cases in anterior urethras and 11 cases in posterior urethras.The grafts were transplanted onto the opened urethras in the first stage;6 months later, the new urethras were shaped with the second stage urethroplasties in 14 patients.There patients succeeded in single-stage urethroplasties. The urethras and bladders were washed with antibiotic solution everyday after urethroplasties. Results Good and satisfactory results were obtained in 15 cases 6 months after urethroplasties, regardless of the strictured sites and lengths. Maximal urinary flow rates ranged 14-32 ml/s. There were 2 cases accompanied with complications 6 months after urethroplasties,1 case of fistula was repaired,1 case of severe urethral stricture was reconstructed with opposite side free postauricular graft later. Three patients had mild urethral strictures 6 months after urethroplasties, they were cured with urethral dilatations for 4-8 times. Conclusion Reconstruction of complex urethral stricture with free postauricular graft is a good and effective method to treat long or complex urethral strictures, especially for patients without adequate foreskin or penis skin.
出处
《中国修复重建外科杂志》
CAS
CSCD
2004年第3期195-197,共3页
Chinese Journal of Reparative and Reconstructive Surgery
