经尿道等离子电切治疗复杂性后尿道狭窄的临床疗效分析

发布时间：2018-01-27 16:18

本文关键词： 等离子电切复杂性后尿道狭窄　出处：《青海大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的通过对比经尿道等离子电切及开放手术在治疗复杂性后尿道狭窄中的临床疗效，评价两种手术方式的临床价值，为复杂性后尿道狭窄治疗的手术方式选择提供依据。方法选择2010年1月至2013年1月期间，于青海省人民医院泌尿外科住院治疗的80例复杂性后尿狭窄患者，其中40例患者应用等离子电切治疗（为等离子电切组），其余40例患者采用经会阴尿道狭窄段切除术加端端吻合术（为开放手术组）。术后随访12月，收集两组患者临床资料，进行统计学分析，对比两组的临床疗效。结果等离子电切手术组和开放手术组手术时间分别为142.2±17.1min、75.1±6.2min，手术中出血量分别为426.0±61.3ml、15.8±6.9ml，术后住院时间分别为13.1±1.6d、9.1±1.5d，术后行尿道扩张的总次数分别为17.2±5.7次、7.5±4.1次，术后第3月复查最大尿流率分别为17.3±3.6ml／s、17.1±4.0ml／s。开放手术组34例患者治愈，6例失败，治愈率85%；等离子电切组35例治愈，5例失败，治愈率87.5%。失败患者表现为尿线细，尿道造影显示后尿道再次狭窄，予以定期尿道扩张后能改善排尿，无需再次手术治疗。开放手术组术后并发症包括1例尿失禁和勃起功能障碍1例，，等离子体柱电极加电切组无术后并发症发生。结论1.相对于开放手术，等离子电切拥有手术操作简便快捷、并发症少、损伤小、愈合快的特点，可作为未并发尿道憩室及尿瘘的复杂性后尿道狭窄的治疗首选。 2.两组的术后尿道扩张次数均随时间的延长，呈逐渐减少的趋势，以术后3月内最为频繁，相同时间段内，等离子电切手术可明显减少术后尿道扩张的频率及次数，可有效的减轻患者的痛苦。
[Abstract]:Objective to evaluate the clinical value of transurethral plasma resection and open surgery in the treatment of complex posterior urethral stricture. To provide the basis for the surgical treatment of complex posterior urethral stricture. Methods from January 2010 to January 2013, 80 patients with complicated post-urinary stricture were treated in the Department of Urology, Qinghai Provincial people's Hospital. Among them, 40 patients were treated with plasma electroresection (plasma resection group), and the other 40 patients were treated with transurethral urethral stricture resection and end-to-end anastomosis (open operation group). Follow up on December. Collect the clinical data of the two groups, carry on the statistical analysis, compare the clinical curative effect of the two groups. Results the operative time of plasma electroresection group and open operation group were 142.2 卤17.1 min and 75.1 卤6.2 min, respectively. The amount of bleeding during operation was 426.0 卤61.3ml / L 15.8 卤6.9ml, respectively, and the postoperative hospitalization time was 13.1 卤1.6days (9.1 卤1.5d). The total times of urethral dilatation were 17. 2 卤5. 7 times and 7. 5 卤4. 1 times, respectively. The maximum flow rate was 17. 3 卤3. 6 ml / s on March. 17.1 卤4.0 ml / s. In open operation group, 6 cases were cured and 6 cases were cured, the cure rate was 85%. In the plasma electroresection group, 35 cases were cured and 5 cases were cured, the cure rate was 87.5%. The failed patients showed fine urethral line, urethrography showed that the posterior urethra was stricture again, and regular urethral dilatation could improve urination. The postoperative complications in the open operation group included one case of urinary incontinence and one case of erectile dysfunction. Compared with open surgery, plasma electroresection has the characteristics of simple and fast operation, less complications, less injury and faster healing. 2. It can be used as the first choice for the treatment of complicated posterior urethral stricture without complicated urethral diverticulum and urinary fistula. 2. The number of urethral dilatation in the two groups decreased gradually with the prolongation of time, and the frequency of urethral dilatation was the most frequent in March, the same time period. Plasma electroresection can significantly reduce the frequency and frequency of urethral dilatation after surgery, and can effectively alleviate the pain of patients.
【学位授予单位】：青海大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699

【参考文献】