筋膜扩张器联合钬激光与传统冷刀治疗男性尿道狭窄疗效比较

Comparison of the curative effect between fascia dilator combined with holmium laser urethrotomy and cold-knife urethrotomy for male urethral stricture

目的比较筋膜扩张器联合钬激光内切开术与传统冷刀内切开术治疗男性尿道狭窄的有效性和安全性。方法回顾性分析2010年1月至2015年1月周口市中医院收治的46例尿道狭窄男性患者的临床资料,其中行筋膜扩张器联合钬激光内切开术(钬激光组)24例,行传统冷刀内切开术(冷刀组)22例。比较2组患者术前及术后最大尿流率(Qmax)、手术时间、术中出血量、术后尿道扩张次数及术后6、12个月的复发率。结果 46例尿道狭窄患者均顺利完成手术。与冷刀组比较,钬激光组患者术中出血量、术后Qmax、平均尿道扩张次数、术后6个月复发率显著降低(P<0.05),但2组患者手术时间、术后12个月复发率比较差异无统计学意义(P>0.05)。钬激光组和冷刀组患者不良反应发生率分别为0.0%和18.2%,冷刀组患者不良反应发生率显著高于钬激光组(P<0.05)。结论与传统冷刀内切开术比较,筋膜扩张器联合钬激光治疗男性尿道狭窄疗效更佳,且不良反应少。

Objective To compare the safety and efficacy of fascia dilator combined with holmium laser urethrotomy for male urethral stricture. Methods The clinical data of 46 cases with male urethral stricture in Department of Urology of Zhoukou Traditional Chinese Hospital from January 2010 to January 2015 was analyzed,including 24 cases who accepted fascia dilator combined with holmium laser urethrotomy（ holmium laser group） and 22 cases who accepted cold-knife urethrotomy group（ cold-knife group）. The clinical data of these patients including preoperative and postoperative Qmax,stricture length,the operating time,the bloodloss volume,the number of postoperative urethra dilation,recurrence-free rate at 6 and 12 months postoperatively. Results All the operation for 46 patients were successful. Compared with cold-knife group,the bloodloss volume,postoperative Qmax the average number of time for postoperative urethra dilation and recurrence-free rate at 6 months postoperatively were lower significantly in holmium laser group（ P〈0. 05）. There was no significant difference in the operating time,recurrence-free rate at 12 months postoperatively between the two groups（ P〉0. 05）. The adverse reaction rate in holmium laser group（ 0. 0%） was significantly lower than that in cold-knife group（ 18. 2%）（ P〈0. 05）. Conclusion Fascia dilator combined with holmium laser urethrotomy is a safe,less suffering and effective method for the management of male urethral stricture compared with cold-knife technique.