摘要
目的评价同种异体脱细胞真皮基质(ADM)治疗前尿道狭窄的临床效果。方法回顾性分析2015年9月至2018年2月于北京大学人民医院、中国人民解放军总医院第一附属医院泌尿外科因前尿道狭窄应用ADM行尿道修复手术的45例患者的临床资料。观察患者术后尿流率变化、尿道黏膜覆盖情况以及并发症与转归情况,并进行统计学分析。结果患者术后第1、6、12个月平均最大尿流率分别为(16.9±1.5)mL/s、(15.7±2.1)mL/s及(15.1±2.4)mL/s,显著高于术前(1.3±0.6)mL/s(P<0.05)。10名患者术后12个月行膀胱镜检查,镜下见上述患者尿道上皮黏膜覆盖情况良好。2名患者于术后2~4周出现感染,6名患者于术后7~10个月出现非感染性尿道再狭窄,1名患者于术后5个月出现尿瘘,上述患者给予相应治疗后好转。结论 ADM为前尿道狭窄修复重建手术提供了新的材料选择,效果明显,具有容易获取、操作方便、无需额外行取材手术的优点,但不适用于长段狭窄以及对延展性要求较高的年轻患者使用。
Objective To evaluate the clinical efficacy of acellular dermal matrix (ADM) in the treatment of anterior urethral stricture. Methods The clinical data of 45 patients with anterior urethral stricture treated with urethral repairing by using ADM during Sept.2015 and Feb.2018 were retrospectively analyzed.The changes of urine flow rate,urethral mucosal coverage,complications and prognosis were observed and analyzed statistically. Results The average maximum urine flow rate 1,6 and 12 months after operation was (16.9±1.5)mL/s,(15.7±2.1)mL/s and (15.1±2.4) mL/s,respectively,which was significantly higher than that before operation (1.3±0.6)mL/s ( P <0.05).Cystoscopy was performed in 10 patients 12 months after operation,and well-covered urethral epithelium was observed.Infection occurred in 2 patients 2-4 weeks after operation,noninfectious urethral restenosis occurred in 6 patients 7-10 months after operation,and fistula occurred in 1 patient 5 months after operation.All complications were improved after treatment. Conclusion ADM provides a new choice of material for the repair and reconstruction of anterior urethral stricture.It has the advantages of easy access,simple operation,and no need for additional surgery,but it is not suitable for long-segment stenosis or young patients who require high ductility of penis.
作者
唐旭
张晓威
吴元翼
殷华奇
杜依青
李清
刘士军
徐涛
TANG Xu;ZHANG Xiao-wei;WU Yuan-yi;YIN Hua-qi;DU Yi-qing;LI Qing;LIU Shi-jun;XU Tao(Department of Urology,People s Hospital of Peking University,Beijing 100044;Department of Urology,First Hospital Affiliated to the General Hospital of Chinese People s Liberation Army,Beijing 100048,China)
出处
《现代泌尿外科杂志》
CAS
2019年第2期106-109,共4页
Journal of Modern Urology
关键词
前尿道狭窄
尿道修复
脱细胞真皮基质
anterior urethral stricture
urethral repair
acellular dermal matrix