尿道下裂术后谷氏祛腐生肌液尿道灌注冲洗的临床疗效分析

Analysis of clinical efficacy of flushing Gushi Qufushengji liquid urethral perfusion after hypospadias surgery

目的 观察尿道下裂术后谷氏祛腐生肌液经多孔硅胶双支架管行尿道灌注冲洗的临床疗效.方法 选择聊城市人民医院及聊城市第二人民医院小儿外科及泌尿外科2009.2-2015.3 年住院治疗的212 例尿道下裂患者,按照年龄及尿道下裂术式类型,均衡分为3 组,治疗组1（70 例）于尿道下裂术后,经多孔硅胶双支架管给予庆大霉素联合谷氏祛腐生肌液尿道灌注,治疗组2（71 例）术后灌注冲洗庆大霉素,对照组（71 例）灌注冲洗生理盐水,并对术后各组冲洗液浑浊情况、愈合情况、尿瘘并发症、术后6 个月内尿道狭窄的发生情况,及无尿道狭窄并发症患者尿流率测定情况进行观察和记录.结果 治疗组1 的70 例患者中,发生尿漏4 例,均于4 周后瘘口自然闭合,尿道口狭窄4 例,经尿道扩张后痊愈;治疗组2 的71 例患者中,发生漏尿5 例,均于4 周后瘘口自然闭合,尿道狭窄8 例,5 例经尿道扩张后痊愈,3 例需择期行尿道成形术;治疗组3 的71 例患者中,发生漏尿8 例,4 例于4 周后瘘口自然闭合,4 例需二期行尿道瘘修补术,尿道口狭窄11 例,5 例经尿道扩张后痊愈,6 例需择期行尿道成形术.治疗组1 术后冲洗液浑浊情况较治疗组2 及对照组明显为清.尿流率测定情况,治疗组1Qmax 高于治疗组2 及对照组.结论 治疗组1 术后尿道瘘并发症与治疗组2 无明显差别,但较对照组明显降低;尿道狭窄并发症发生率则明显低于治疗组2 及对照组.谷氏祛腐生肌液经多孔硅胶双支架管行尿道灌注冲洗的临床疗效良好,较常规治疗可明显降低术后并发症,特别是尿道狭窄并发症的几率.

Objective To observe the after hypospadias repair Valley＇s Qu Shengji liquid the porous silica gel double stent tube urethral perfusion ofthe clinical efficacy. Methods 212 cases of hypospadias patients and pediatric department of Urology Second Hospital of Liaocheng People＇s Hospital andLiaocheng 2009.2-2015.3 hospital treatment, according to the age and hypospadias type, balanced and divided into 3 groups, treatment group 1 （70 cases） inhypospadias surgery by double stent porous silica gel tube given gentamycin combined with Gushi Qufushengji liquid urethral perfusion treatment group 2 （71cases） perfusion of gentamicin after surgery, the control group （71 cases） perfusion of saline, and each group of washing liquid turbidity, postoperative healing,complications, postoperative urinary fistula occurred within 6 months after the urethral stricture were observed and recorded, and no complications of urethralstricture patients uroflometry case. Natural natural cured after natural result in the treatment group of 70 cases of patients, the incidence of urinary fistula in 4cases, 4 weeks after the fistula closed urethral stenosis in 4 cases, the urethral dilatation; treatment group 2 of 71 patients, the occurrence of urinary leakage in 5cases, 4 weeks after fistula closure, urethral stricture in 8 cases, 5 cases of the urinary tract dilatation recovered, 3 cases undergoing urethroplasty surgery;treatment group 3 of 71 cases of patients, the occurrence of leakage of urine in 8 cases, 4 cases in 4 weeks after fistula closure, 4 cases need urethral fistularepair, urethral stenosis in 11 cases, 5 cases with urethral dilatation recovered, 6 patients undergoing urethral operation. The treatment group of 1 patients afterwashing liquid turbidity than the treatment group 2 and control group was clear. Uroflometry, 1Qmax of the treatment group was higher than that of thetreatment group 2 and control group. Conclusion the treatment group of 1 postoperative complications of urethral fistula and 2 in the treatment group had nosignificant ifference, but significantly lower than the control group; the complications of urethral stricture rate is significantly lower than the treatment group2 and control group. Gu＇s Qufushengji fluid through a porous double silicone stent urethral perfusion of the clinical efficacy of good, compared withconventional treatment can significantly reduce the postoperative complications, especially the risk of complications of urethral stricture.