输尿管联合球囊扩张导管治疗男性尿道狭窄的有效性及安全性研究

Study on the efficacy and safety of ureteral balloon catheter in treatment of male urethral stricture

目的探讨输尿管镜联合球囊扩张导管在男性尿道狭窄治疗中的应用效果。方法前瞻性选取2017年1月至2017年12月山西省大同市第三人民医院收治的尿道狭窄男性患者70例为研究对象,按照随机数字表法将患者分为对照组和观察组,每组各35例,对照组患者接受传统尿道扩张术治疗,观察组患者接受输尿管镜联合球囊扩张导管治疗,观察两组患者的治疗效果、手术前后尿道功能变化及术后并发症发生情况。结果观察组患者治疗总有效率为97. 14%,高于对照组的80. 00%,差异具有统计学意义(P <0. 05)。术前两组患者尿道功能相关指标(最大尿流率分别为10. 39±2. 08 ml/s、10. 41±2. 15 ml/s)、(膀胱残余尿量分别为35. 93±4. 12 ml/s、35. 71±4. 01 ml/s)、差异无统计学意义(P> 0. 05),术后均有改善,观察组患者术后3个月最大尿流率(20. 37±3. 82 ml/s)明显高于对照组(17. 47±3. 24ml/s),差异具有统计学意义(P <0. 05);膀胱残余尿量(21. 52±3. 46 ml/s)明显低于对照组(25. 97±3. 494 ml/s),差异有统计学意义(P <0. 05)。观察组术后并发症发生率(2. 86%)明显低于对照组(17. 14%),差异有统计学意义(P<0. 05)。结论在男性尿道狭窄治疗中,应用输尿管镜联合球囊扩张导管,效果显著,可明显改善患者尿道功能,且安全性高,值得推广。

Objective To explore the effect of ureteroscopy combined with balloon dilatation catheter in treatment of male urethral stricture.Methods Seventy male patients with urethral stricture admitted to the Third People’s Hospital of Datong City,Shanxi Province,during January 2017 to December 2017 were prospectively selected as study objects.According to the random number table method,all these patients were divided into control group and observation group,35 cases in each group.Patients in control group were treated with traditional urethral dilatation,while those in observation group were treated with ureteroscopy combined balloon dilatation.The therapeutic effect,changes of urethral function before and after operation and the occurrence of postoperative complications were observed.Results The total effective rate of observation group was97.14%,higher than 80.00%of control group,and the difference was statistically significant(P<0.05).There was no significant difference in related indexes of urethral function between these two groups before operation(Qmax was 10.39±2.08 ml/s,10.41±2.15 ml/s,Bladder residual urine volume(RUV)was 35.93±4.12 ml/s,35.71±4.01 ml/s)and after operation(P>0.05).The maximum urinary flow rate(20.37±3.82 ml/s)in observation group was significantly higher than that of control group(17.47±3.24 ml/s),and the difference was statistically significant(P<0.05).The residual urine volume of bladder(21.52±3.46 ml/s)was significantly lower than that of control group(25.97±3.494 ml/s),and the difference was statistically significant(P<0.05).There was only one case with fever in observation group,and the incidence of complications was 2.86%.In Comparison with 17.14%of control group,the incidence of complications was significantly lower(P<0.05).In observation group,only 1 cases with fever was found after operation,the incidence of complications was 2.86%,compared with that of(17.14%)in control group,it is obviously lower,and the difference was statistically significant(P<0.05).Conclusion Ureteroscopy combined with balloon dilatation catheter is effective in treatment of male urethral stricture,and it can significantly improve the urethral function of patients.It is safe and worthy to be promoted.