创伤性尿道狭窄术后吻合口形态超声诊断与手术结果的对照

A comparison of ultrasound diagnosis and pathologic changes on urethral anastomotic site in traumatogenic urethral strictures postoperatively

目的 评价创伤性尿道狭窄术后吻合口形态超声诊断的可靠性。方法 对68例创伤性尿道狭窄术后排尿困难者尿道吻合口形态进行超声观察,并与再次手术结果对照。结果 尿道吻合口形态表现共4种,即狭窄疤痕形成(43例)、假道(12例)、尿道活瓣(4例)和狭窄合并关闭不全(9例)。超声形态表现类型和定位诊断均经手术证实。超声对手术吻合口狭窄疤痕长度和深度估测的相关系数γ分别为0.97,0.86,P<0.01。结论 尿道超声成像是评价尿道狭窄术后吻合口形态可靠的诊断方法,有助于指导术后排尿困难病例的临床正确处理。

Objective To evaluate reliability of ultrasound diagnosis of urethral anastomotic site postoperatively morphologically. Methods Sixty - eight cases of patients with dysuria postoperatively underwent sonourethrography and operation. Results There were iour echogenic appearances on urethral anastomotic site: (1)scar formation with urethral stictures(43 cases) , (2)false passages(l2 cases) , (3)urethral flap valves(4 cases) and (4) strictures with membraneous closure insufficiency (9 cases) .All sonographic findings including diagnosis of abnormal changes and location of lesions were confirmed by open urethoplasty and visual internalurethrotomy. There were good correlation between ultrasound and operation for estimation extent of periurethral anastomosis scarring. Conclusions Sonourethragraphy is a reliable method to evaluate pathologic morphologic changes on urethral anastomosis in patients with dysuria postoperatively. It will be helpful to treat correctly after operation.