尿道修补吻合术与输尿管镜下尿道会师术治疗尿管放置失败尿道骑跨伤临床对比研究

Clinical comparative study of urethral anastomoses and ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure

目的：探讨尿道修补吻合术与输尿管镜下尿道会师术治疗尿管放置失败尿道骑跨伤临床疗效及安全性的差异。方法选取尿管放置失败尿道骑跨伤患者90例，依据患者意愿分为A组（45例）和B组（45例），分别采用尿道修补吻合术与输尿管镜下尿道会师术治疗。比较两组患者手术时间、术中出血量、住院时间及术后并发症发生情况。结果 B组患者手术时间、术中出血量、住院时间均低于A组[（26.15±10.41）min比（71.93±14.50）min，（22.37±7.41）ml比（50.70±13.25）ml，（3.22±0.97）d比（5.19±1.43）d]，差异有统计学意义（P＜0.05）。随访6个月，B组患者并发症发生率为2.22%（1/45），显著低于A组的13.33%（6/45），差异有统计学意义（P＜0.05）。结论输尿管镜下尿道会师术治疗尿管放置失败尿道骑跨伤可显著缩短手术时间，减少术中创伤，加快术后康复进程，并有助于降低围手术期并发症发生的风险。

Objective To investigate the clinical effects and safety of urethral anastomoses and ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure. Methods Ninety patients with urethral straddle injury and catheter placement failure were chosen and divided into A group （45 patients, choosing urethral anastomoses） and B group （45 patients, choosing ureteroscopy urethral realignment）. The operation time, intraoperative blood loss, hospital staying time and peri-operation complications in both groups were compared. Results The operationtime, intraoperative blood loss, hospital staying time in B group were significantly lower than those in A group： （26.15 ± 10.41） min vs. （71.93 ± 14.50） min, （22.37 ± 7.41） ml vs. （50.70 ± 13.25） ml, （3.22 ± 0.97） d vs. （5.19 ± 1.43） d, P〈0.05. After 6 months′follow-up, the clinical indicators in peri-operation period of B group were significantly better than those in A group （P〈0.05）. The complications incidence in B group was significantly lower than that in A group： 2.22%（1/45） vs. 13.33%（6/45）, P 〈0.05. Conclusions The technology of ureteroscopy urethral realignment in the treatment of urethral straddle injury and catheter placement failure can efficiently shorten the operation time, reduce the degree of trauma and accelerate the rehabilitation process, and it is helpful to reduce the risk of complications in peri-operation period.