对端旋切技术在尿道闭锁治疗中的应用

Rotator incision in the endourethral surgery for urethratresia

目的 探寻腔内治疗尿道闭锁的安全切开方法。 方法 运用尿道对端旋切技术治疗16例尿道闭锁 ,2例旋切后未行进一步处理 ,余 14例在旋切后用电刀行瘢痕切除。术后均留置导尿管 4～ 6周 ,拔管后行尿流率等检查。 结果 16例对端旋切打通均一次成功 ,旋切过程 18～ 33min ,平均 2 5min。 2例仅行旋切治疗者拔管后排尿欠佳 ,Qmax分别为 9ml /s及 7ml/s ,二期电切后恢复正常排尿 ,Qmax >16ml/s。余 14例拔管后恢复正常排尿 ,Qmax均 >16ml/s。 16例随访 8～4 4个月 ,平均 2 7个月 ,无 1例出现并发症。 结论 对端旋切技术简便、准确、安全 ,为腔内治疗尿道闭锁的一种新方法 ,旋切后对闭锁段尿道瘢痕进一步切除是达到满意效果的关键。

Objective To introduce an optimal incision technique in the endourethral surgery for urethratresia. Methods Sixteen patients suffering from urethratresia were managed by endourethral surgery,2 of them treated with rotator incision and the other 14 with rotator incision plus transurethral scar electrosectomy.The efficacy of the treatment was evaluated by Qmax. Results Successful incisions were achieved in all patients,the duration of procedure being from 18 to 33 min,with a mean of 25 min.Two patients with rotator incision had dysuria (Qmax 9 and 7 ml/s) after the surgery and accepted transurethral resection of scar again.The other 14 patients with rotator incision plus transurethral scar electrosectomy had good voiding.Qmax was more than 16 ml/s in all patients after operation. Conclusions Rotator incision is a safe,simple,efficacious incision technique in the endourethral surgery for urethratresia,and scar electrosectomy is essential for successsful outcome.