尿道球部损伤的两种急诊处理方法比较

Comparative of Two Emergency Treatment Methods of Bulbar Urethra Rupture

目的比较尿道球部损伤腔内会师术和开放性手术的治疗效果。方法2000-2005年6月对尿道球部损伤患者中采用膀胱镜下尿道会师术10例,开放性手术12例,对两种急诊术式的手术时间、术中出血量、术后住院时间及临床疗效进行对比研究。结果腔内会师组9例置管成功,1例因尿道球部完全断裂改行开放性手术。开放手术组13例中11例手术成功。两组的手术时间、术中出血量及术后住院时间间差别均有显著性意义（P〈0.05）,两组尿流率间差别无显著性意义（P〉0.05）。结论膀胱镜下尿道会师术与开放性手术相比具有手术时间短、住院时间短、疗效相似的特点,尤其适合于尿道球部部分断裂者;而对于腔内会师术失败或尿道球部完全断裂者仍可采用开放性手术。

Objective To evaluate the urethroscoscopic and open surgical treatment of bulbar urethra rupture. Methods From January 2000 to June 2005, a total of 22 patient with urethrobulbar rupture were operated, 10 cases with urethroscopic surgery, 9 cases with open surgery. The operation time, blood loss, hospitalization time and therapeutic effectiveness of these two methods were compared. Results 9 cases with urethroscopic surgery were successfully treated at a single session. Failure occurred in 1 because of complete urethrobulbar rupture. Compared to open surgery, urethroscopic surgery had shorter operation time, less blood loss and shorter hospitalization stay （ P 〈 0. 05 ）, but there was no significant chang of uroflowmetry in two groups （ P 〉 0. 05）. Conclusion Urethroscopic urethral reunion could obtain the same therapeutic effect as open surgery with short operation time, simple procedure, minimal invasion. Therefore we recommend this procedure as the initial step in most patients with partial bulbar urethral disruption, and open surgery is needed when urethroscopic surgery was failure or complete urethrobulbar rupture occured.