高频超声下楔形切除术治疗男性淋球菌性尿道旁管扩张11例临床研究

High-frequency ultrasound imaging-guided wedge resection for the treatment of paraurethral duct dilatation following gonococcal paraurethral duct infection in 11 male patients

目的 探讨楔形切除术治疗淋球菌感染后继发男性尿道旁管扩张的疗效。方法 高频超声指导下，用楔形切除术切除男性淋球菌性尿道旁管扩张11例。详细记录患者术中时间、术中出血量、伤口愈合时间、并发症。手术后4周内尿道外口小孔消失，挤压原小孔处，无分泌物自原小孔处溢出，高频超声未能检测到管道状回声判为痊愈。手术4周后尿道外口仍有小孔，挤压后仍有分泌物自小孔处溢出，高频超声仍能检测到管道状回声判为无效。结果 11例患者手术时间14 ~ 23 min［（19.19 ± 2.71） min］、术中出血量8 ~ 14 ml［（11.09 ± 2.07） ml］、伤口愈合时间13 ~ 17 d［（14.91 ± 1.45） d］。10例痊愈，1例无效。均无并发症,龟头均无缺损。结论 楔形切除术治疗男性淋球菌性尿道旁管扩张是一种有效的治疗方法。

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes （range, 14 - 23 minutes）, the average amount of bleeding during the surgery was 11.09 ± 2.07 ml （range, 8 - 14 ml）, and the average period of wound healing was 14.91 ± 1.45 days （range, 13 - 17 days）. Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.