摘要
目的探讨顺-逆联合腔内尿道会师术治疗急性尿道损伤的临床疗效及应用价值。方法回顾性分析该院2010年2月-2014年6月采用顺-逆联合腔内尿道会师术治疗急性尿道损伤22例临床资料。先经皮膀胱穿刺,建立膀胱造瘘通道,输尿管镜顺行留置导丝在尿道断端作标引,再经尿道逆行进镜寻找导丝,循导丝留置尿管,恢复尿道连续性。结果 21例Ⅰ期成功会师,其中1例因后尿道长段损伤及合并严重骨盆骨折,仅作膀胱造瘘尿流改道,待病情稳定3个月后行尿道成形术治疗。术后随访6～24个月,出现尿道狭窄2例。复查最大尿流率为12.5～24.8 ml/s,平均20.5 ml/s,残余尿量均〈20 ml,无尿失禁、无尿瘘和无勃起功能障碍。结论顺-逆联合腔内尿道会师术治疗尿道损伤,手术时间短,创伤小,会师成功率高,临床疗效佳,术后并发症少,可作为急诊治疗尿道损伤的首选方法。
【Objective】To explore the clinical effects and application value of Antegrade-retrograde joint cavity urethral realignment in treatment of acute urethral injury.【Methods】The clinical data of 22 cases, who were treated with Antegrade-retrograde joint cavity urethral realignment between February 2010 to June 2014 in our hospital,were analyzed retrospectively. First, the bladder was punctured to establish the cystostomy channel, and the guidewire was indwelled in stump by an antegrade access for indexing, then the ureteroscope was inserted in urethral canal by a retrograde acess to look for the guidewire and indwell catheter by following it, and urethra continuity was recovered. 【Results】Twenty-one cases out of 22 were rendezvoused successfully in stage Ⅰ, only 1 case was not successful because of long urethral injury and serious pelvic fracture, with only maked for cystostomy. He was treated by urethroplasty after three months. All patients were followed up for 6 to 24 months, and urethral stricture happened in 2 cases. The review results showed that the maximum flow rate was 12.5～24.8 ml/s with an average of 20.5ml/s, residual urine volume was less than 20 ml. No incontinence, no urinary fistula, no erectile dysfunction was found. 【Conclusion】Because of shorter operative time, minimally invasion, a high success rate of join forces, good clinical efficacy, less postoperative complications, Antegrade-retrograde joint cavity urethral realignment can be used as a first choice for treating urethral injury in emergency department.
出处
《中国内镜杂志》
北大核心
2015年第9期991-994,共4页
China Journal of Endoscopy
