男性急性钝性尿道损伤后发生尿道狭窄的影响因素

目的探讨男性急性钝性尿道损伤后发生尿道狭窄的影响因素。方法回顾性分析2008年8月至2018年8月94例钝性尿道损伤患者的临床资料,并进行随访。统计尿道狭窄发生率;将患者年龄、治疗时间、尿道损伤部位、损伤程度、即刻治疗方法、引流尿液方式、留置导尿管时间等进行Cox比例风险回归分析,确定潜在影响因素。结果随访31例患者出现尿道狭窄,29例出现在6个月内。单因素分析显示,尿道损伤部位、损伤程度、即刻治疗方法和引流方式与尿道狭窄的形成有关(P=0.0043、0.0011、0.0082、0.0123);多因素分析显示,尿道损伤程度和即刻治疗方法是独立影响因素(P=0.0049,0.0143)。尿道损伤部位与尿道损伤程度相关(P=0.0031),即刻治疗方法与排尿方式有相关(P=0.0151)。结论尿道狭窄是钝性尿道损伤后常见的并发症,多发生在尿道损伤后半年内。尿道损伤的程度和即刻治疗方法对这一并发症的发生有较大的影响。

Objective To identify potential factors that may afiect urethral stricture formation in male patients experiencing acute blunt urethra injury.Methods Ninety-four patients with blunt urethral injuries treated at our hospital between August 2008 and August 2018 were analyzed,and all patients were followed up for at least two years.Incidence of urethral stricture was calculated;and patients'age,time to treatment,location of urethral injury,grade of urethral injury,immediate treatment methods,ways of urinary drainage and indwelling time of urethral catheter were entered into a Cox proportional hazard regression model to identify potential influence factors.Results During follow-ups,urethral stricture developed in 31 patients(32.98%),and most cases(29 cases,93.55%)were observed within six months.Univariate analysis revealed that location of urethral injury,grade of urethral injury,immediate treatment methods and ways of urinary drainage were related to urethral stricture formation(P=0.0043,0.0011,0.0082,0.0123,respectively);while multivariate analysis further manifested that only grade of urethral injury and immediate treatment methods were independent influence factors(P=0.0049,0.0143).Significant correlations were respectively seen between location of urethral injury and grade of urethral injury(P=0.0031),and between immediate treatment method and way of urinary drainage(P=O.O151).Conclusion Urethral stricture is a common complication after blunt urethral injury that mosdy develops within half a year.This complication can be greatly afiected by grade of urethral injury and immediate treatment methods.