双镜联合下尿道会师术治疗急性后尿道完全断裂的临床应用分析

Clinical application of double-mirror combined with lower urethral surgery in the treatment of acute posterior urethral rupture

目的探讨双镜联合下尿道会师术治疗急性后尿道完全断裂的临床效果。方法选取2013年2月~2017年3月期间本院泌尿外科收治的急性后尿道完全断裂患者68例,根据治疗方法的不同,将所有患者分为对照组和观察组,各34例,对照组患者给予耻骨上膀胱切开尿道会师术进行治疗,观察组采用双镜联合下尿道会师术治疗,观察两组患者手术时间、术中出血量、住院时间及术后并发症。结果观察组患者手术时间为(69.89±7.32)min、术中出血量为(51.23±6.82)mL、住院时间(7.69±2.11)d与对照组的(92.34±8.35)min、(73.48±8.92)mL、(9.79±2.56)d相比较,观察组均显著低于对照组(P<0.05);对照组患者出现1例(占2.94%)勃起功能障碍患者、尿失禁2例(占5.88%)、尿道狭窄5例(占14.71%),观察组患者术后1例(占2.94%)患者有尿道狭窄现象出现,行尿道扩张后正常排尿,未出现勃起功能障碍和尿失禁的现象,两组患者并发症差异显著(X^2=5.1000,P=0.0239)。结论双镜联合下尿道会师术治疗急性后尿道完全断裂术后并发症较少、手术时间短、术中出血量较少,临床应用前景广阔,

Objective To explore the clinical effect of double mirror combined with urethral surgery in the treatment of acute posterior urethral rupture.Methods Sixty-eight patients with acute posterior urethral rupture were randomLy divided into control group and observation group according to different treatment methods.The patients were divided into control group and observation group.The patients in the control group were given the treatment of the bladder on the suprapubic incision of the urethra,and the observation group was treated with double mirror combined with lower urethral surgery.The operation time,intraoperative blood loss,hospitalization time and postoperative complications were observed.Results The operation time was(69.89±7.32) min in the observation group,(51.23±6.82) mL,the time of hospitalization(7.69±2.11) d and the control group(92.34±8.35) min,(73.48±8.92)mL(P<0.05).In the control group,there were 1 patient(2.94%) patients with erectile dysfunction,2 cases of urinary incontinence,2 cases of urinary incontinence,2 cases of urinary incontinence,2 cases of urinary incontinence(5.88%),urethral stricture in 5 cases(14.71%),the observation group of patients after surgery in 1 case(2.94%) patients with urethral stricture phenomenon,normal urination after urethral dilatation,no erectile dysfunction and urinary incontinence of the two groups of patients with significant differences in complications,statistical results show(χ~2=5.1000,P=0.0239).Conclusion There is less complication after operation in the treatment of acute posterior urethral rupture,less operation time,less intraoperative blood loss,wide clinical application prospect.