输尿管镜下置导尿管治疗前尿道损伤临床分析

Clinical analysis of treatment of anterior urethral injury by putting urethral catheter per urethra with ureteroscope

目的探讨微创方法治疗前尿道损伤的疗效。方法回顾性分析30例输尿管镜尿道置管术(腔内组)和20例开放性尿道吻合术(开放组)治疗球部尿道断裂的临床资料,比较两组手术时间、术中失血量、术后住院时间及术后尿道狭窄发生率等指标。结果术后尿瘘和出血发生率差异无显著性,但腔内组术后住院时间、手术时间和术中失血量均显著少于开放组(P<0.05),术后随访12个月,治愈率、术后尿道狭窄、尿失禁和勃起障碍均显著少于开放手术组(P<0.05)。结论采用输尿管镜下置尿管治疗前尿道损伤是较有效的治疗方法。

[Objective] To approach therapeutic efficacy of method in the treatment of anterior urethral injury by micro-damage.[Methods] 30 cases treated by ureteroscopy（group of intracavitary） and 20 cases treated by direct end-to-end reanastomosis for bulbar urethral injuries（group of break） were retrospectively analyzed.Operation time,bleeding,urethral stricture and index were compared between two groups.[Results] Incidence of bleeding after operation and urinary fistula of the ureteroscopic group and the open surgical group had no significant difference,but the ureteroscopic group had significant shorter operation time,less blood loss and shorter hospital stay compared with the open surgical group（P 0.05,P 0.01）.The patients were followed up for 12 months after operation,the ureteroscopic group had significant less urethral stricture,cure rate,anischuria and ED than the open surgical group（P 0.05）.[Conclusion] The treatment of putting urethral catheter per urethra with ureteroscope is believed to be the most ideal surgical procedure for the treatment of anterior urethral injury.