后尿道断裂急诊局麻下膀胱穿刺造瘘联合输尿管镜尿道会师术应用效果

Effect of emergency cystostomy combined with ureteroscopy urethral realignment under the local anesthesia in posterior urethral rupture

目的 探究局麻下膀胱穿刺造瘘联合输尿管尿道会师术急诊后尿路断裂的临床效果.方法 回顾性分析本院30例后尿道断裂患者的临床资料,其中行局麻下膀胱穿刺造瘘联合输尿管镜尿道会师术治疗的14例患者的临床资料作为研究组,行尿道会师术的16例患者的临床资料作为对照组,比较两组手术治疗数据及随访期间并发症情况.结果 研究组手术时间及术中出血量较对照组显著减少,差异具有统计学意义（P＜0.05）,术后最大尿流率及残余尿量两组比较差异无统计学意义（P＞0.05）;随访期间研究组总并发症发生率为7.14％ （1/14）,显著低于对照组37.50％ （7/16）,差异具有统计学意义（P＜0.05）.结论 局麻下膀胱穿刺造瘘联合输尿管镜尿道会师术较常规尿道修补术可显著缩短手术时间,减少术中出血量,创伤小,安全性高且并发症少,为临床治疗后尿道断裂理想方法.

Objectives To investigate the effect of emergency cystostomy combined with ureteroscopy urethral realignment under the local anesthesia in posterior urethral rupture.Methods The clinical data of 30 patients with posterior urethral rupture in our hospital were analyzed retrospectively,and there were 14 patients who were treated with emergency cystostomy combined with ureteroscopy urethral realignment under the local anesthesia as the study group,while the other 16 cases who were treated with urethral realignment as the control group.The operation data and complications during the following -up period were compared betweeen the two groups.Results The operation time and amount of bleeding during operation in the study group were significantly decreased compared with those in the control group,and the differences were statistically significant （P 〈 0.05）,while the differences in the postoperative maximum urinary flow rates and residual urine volume were not statistically significant （P 〉0.05）.The incidence rate in the study group during the following-up period was 7.14%,which was significantly lower than that of 37.50% in the control group,and the difference was statistically significant （P 〈 0.05）.Conclusions The treatment of cystostomy combined with ureteroscopy urethral realignment under the local anesthesia is similar with the conventional urethral repair,but it can significantly shorten the operation time and reduce the amount of bleeding,intraoperative trauma,high safety and less complications,which is an ideal treatment method of posterior urethral rupture.