经尿道2μm激光治疗外伤性尿道狭窄与闭锁的应用研究

发布时间：2018-05-08 12:14

本文选题：尿道狭窄或闭锁 + μm激光　；参考：《微创泌尿外科杂志》2013年05期

【摘要】：目的:探讨经尿道2μm激光尿道内切开术治疗外伤性尿道狭窄与闭锁的治疗效果。方法:50例外伤性后尿道断裂行耻骨上膀胱造瘘术和尿道会师术后再次尿道狭窄或闭锁患者,均经术前积极准备后采用2μm激光直视下尿道内切开术治疗,最大尿流率(MFR)、国际前列腺症状评分(IPSS)、生活质量评分(QOL)作为评价手术效果的3个指标,分别于术前、术后拔除尿管、出院3个月后复查所测得。并行统计学分析。结果:50例患者经积极术前准备后均采用2μm激光直视下尿道内切开术治疗,术中均无直肠损伤、尿瘘形成、大出血等,术后留置尿管2~4周,拔除尿管后,最大尿流率从术前的(2.7±0.8)ml/s改善为(15.7±2.1)ml/s,3个月后复查平均最大尿流率为(16.1±2.1)ml/s,IPSS评分从术前的(28.7±5.1)分改善为术后拔除尿管时的(10.2±5.4)分,术后3个月时的(8.8±5.4)分,QOL从术前的(5.7±0.5)分改善为术后拔管时的(2.1±1.7)和术后3个月时的(1.8±1.7)分,47例患者拔除尿管后尿道狭窄没有复发,3例患者复发尿道狭窄,其中1例术后拔除尿管1周出现尿失禁,50例患者拨除尿管后均按原则定期扩尿道,必要时膀胱镜下扩尿道治疗,配合排尿锻炼后全部改善。结论:经尿道2μm激光尿道内切开术是治疗外伤性尿道狭窄或闭锁的一种适宜的好方法。
[Abstract]:Objective: to investigate the effect of transurethral 2 渭 m laser urethrotomy for traumatic urethral stricture and atresia. Methods 50 patients with traumatic posterior urethral rupture underwent suprapubic cystostomy and reurethral stricture or atresia after urethral union. MFR, IPSS and QOLs were used as three indexes to evaluate the effect of operation. The urethral catheter was removed before and after operation, and was rechecked 3 months after discharge. Parallel statistical analysis. Results all 50 patients were treated with 2 渭 m laser assisted hypospadias urethrotomy after active preoperative preparation. There were no rectal injury, urinary fistula formation, massive bleeding, etc. After 2 weeks of indwelling urethral catheter, the urethral catheter was removed. The maximum flow rate was improved from 2. 7 卤0.8)ml/s to 15. 7 卤2. 1 ml / s. After 3 months, the average maximum flow rate was 16. 1 卤2. 1 卤2. 1 ml / sIPSS score from 28. 7 卤5. 1 before operation to 10. 2 卤5. 4 at the time of extubation. The QOL at 3 months after operation was improved from 5.7 卤0.5) to 2.1 卤1.7 at extubation and 1.8 卤1.7 at 3 months after operation. 47 patients with urethral stricture after extubation had no recurrence of urethral stricture and 3 patients with recurrent urethral stricture. One patient with urinary incontinence 1 week after extubation had urethral dilatation in accordance with the principle of regular urethral dilatation. When necessary, urethral dilatation under cystoscope was all improved in combination with urination exercise. Conclusion: transurethral 2 渭 m laser urethrotomy is an appropriate and effective method for the treatment of traumatic urethral stricture or atresia.
【作者单位】：山西医科大学研究生院;山西医学科学院山西大医院泌尿外科;
【分类号】：R699

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