尿道损伤术后局部组织变化的动物实验观察

A study of the histopathological features of injured urethra managed by urethral realignment or suprapublic cystotomy

目的 了解不同手术方式处理尿道损伤后局部组织变化情况 ,为临床选择治疗方案提供实验依据。 方法 成年雄性杂种犬 2 0只 ,每组 10只 ,分为尿道会师和膀胱造瘘两组。术后不同时期取材行HE、电镜、免疫组化及尿道造影 ,比较两组结果。 结果 会师组 8周时尿道修复基本完成 ,32周闭塞段长 2 .5cm。造瘘组各时期均未见尿道再生 ,32周时尿道闭塞长 3 .8cm。 结论 尿道会师可有效减轻断裂后尿道断端移位及回缩 ,支架导管在损伤尿道的再生修复中起重要作用。一期造瘘可使尿道断端间距延长 ,增加二期手术难度。

Objective To study the histopathological features of injured urethra managed by urethral realignment or suprapublic cystotomy and to sum up the experience on its treatment. Methods Urethral realignment or suprapublic cystotomy were carried out for 20 dogs as the instant management;tissue specimens from the two groups were studied using hematoxylin and eosin stain,immunohistochemistry and electron microscopy and the result has been studied. Results Regeneration of urethra was demonstrated in the urethral realignment group at 8 weeks after urethral injured whereas regeneration has been in the suprapublic cystotomy group.The average length of urethral emphraxis was 3.8 cm in the suprapublic cystotomy group whereas that of urethral stricture only 2.5cm in the urethral realignment group at 32 week. Conclusions Urethral realignment might be the treatment of choice for the instant managerment of urethral disruption as compared with suprapublic cystotomy.