严重后尿道断裂的内窥镜重建术

ENDOSCOPIC RECONSTRUCTION FOR SERIOUS TRAUMATIC OCCLUSION OF POSTERIOR URETHRA

创伤性后尿道断裂伴有严重骨盆骨折、重度失血性休克和多发性复合性损伤时，最重要的是首先正确治疗严重复合伤，恢复尿道连续性是次要的。我们早期仅行耻骨上膀胱造瘘术，待３～６个月形成后尿道闭锁后，再择期施行后尿道的内窥镜重建术。自１９８４至１９９４年３月，我们采用改进的内窥镜技术治疗２７例男性严重后尿道闭锁，其中２６例获得满意效果（成功率９６．３％）。病人平均年龄３６．１岁（３～６５岁）。作者对改进的内窥镜重建术及其治疗后尿道损伤的各种早期手术优缺点进行了讨论。

When traumatic posterior urethral transection occurs with serious pelvic fracture,the patient is usually under severe hemorrhagic shock and multiple injuries.It Is of prime importance to treat the serious associated injuries promptly.As for the urethral disruption,a simple suprapubic cystostomy at the moment is preferred.Occlusion of the posterior urethra would eventually appear and can be managed endoscopically 3～6 months later.Twenty seven such cases were thus managed from 1984 to March 1994 with an improved endoscopic technique with a success rate of 96.3%(26/27).The age of the male patients ranged from 3 to 65 with a mean of 31.6 years of age.The advanages of this technique and the merits and demerits of various primary urethral reconstion procedures are discussed.