球囊扩张器联合钬激光治疗尿道狭窄的临床研究
发布时间：2018-07-13 14:35
【摘要】：目的： 探讨球囊扩张器联合钬激光治疗尿道狭窄的临床疗效及安全性,以及手术效果的影响因素。 方法： 回顾性分析自2012年9月2014年2月,我院使用球囊扩张器联合钬激光治疗50例尿道狭窄患者的过程。通过记录和监测患者尿道狭窄类型、手术时间、术中出血量、术后并发症、术后导尿管留置时间、IPSS评分、QQL评分、最大尿流率(Qmax)、治愈率等相关临床指标,并进行统计学分析,评估该手术方式治疗尿道狭窄的疗效,并对该手术的围手术期准备、手术方法、术中注意事项、术后并发症的发生原因及防治等进行经验总结。 结果： 本组36例患者一次性手术成功,手术时间20min-70min,平均45.7±4.8min,术中出血量5-20ml,平均10ml,术后拔管时间为3-29d,平均(20.7±4.2)d,首次拔管后均排尿通畅,无尿潴留发生,复查Qmax平均(21.4±4.4)ml/s, IPSS平均(8.7±2.3),QOL平均(1.3士0.5)较术前有显著性差别(P0.05),术后第3个月复查Qmax平均(20.3±4.2) ml/s, IPSS平均(8.1士1.6),QOL平均(1.0±0.4),术后第6个月Qmax平均(19.6±3.7)ml/s, IPSS平均(8.4±2.3),QOL平均(1.5士0.2)。进行为期3-17个月的随访观察,49例患者随访至今,失访1例,其中X1cm的患者11例治愈,无复发；25例1cm≤X≤3cm的患者中19例治愈或好转,6例复发,其中5例行定期尿道扩张,1例再次行球囊扩张器联合钬激光；13例X3cm的患者中6例治愈或好转,7例复发,其中5例行尿道成形术,1例再次行球囊扩张器联合钬激光。23例单纯性尿道狭窄治愈或好转19例,成功率为82.6%；26例复杂性尿道狭窄治愈或好转17例,成功率为65.4%,二者有明显差别(P0.05)。·术后均无尿道出血、尿道穿孔、尿瘘、尿失禁、尿道膀胱结石等并发症发生。 结论： 1.球囊扩张器联合钬激光治疗尿道狭窄效果满意,且安全性可靠,并发症少,恢复时间快,值得进一步推广应用。 2.其疗效与尿道狭窄的长度相关,Xlcm,球囊扩张器联合钬激光治疗效果确切,可作为首选；1cm≤X≤3cm,可先选择球囊扩张器联合钬激光治疗,失败后可选择其他治疗,如开放手术；X3cm,应选择开放手术。 3.球囊扩张器联合钬激光可作为治疗单纯性尿道狭窄首选方法,对复杂性尿道狭窄也具有明显效果。
[Abstract]:Objective: to investigate the clinical efficacy and safety of balloon dilator combined with holmium laser in the treatment of urethral stricture. Methods: 50 patients with urethral stricture were treated with balloon dilator and holmium laser since Feb. 2012. By recording and monitoring the type of urethral stricture, operative time, intraoperative bleeding volume, postoperative complications, postoperative catheter indwelling time, IPSS score and QQL score, maximum uroflow rate (Qmax), cure rate, and so on, statistical analysis was made. To evaluate the curative effect of the surgical treatment of urethral stricture, and summarize the experience of perioperative preparation, operative method, intraoperative matters needing attention, the causes of postoperative complications and the prevention and treatment of postoperative complications. Results: one time operation was successful in 36 patients, the operative time was 20 min-70 min (mean 45.7 卤4.8 min), the blood loss was 5-20 ml (mean 10 ml), the extubation time was 3-29 days (average 20.7 卤4.2 d) after the first extubation, there was no urine retention after the first extubation. Qmax and IPSS were (21.4 卤4.4) ml / s and (8.7 卤2.3) ml / s, respectively (P 0.05). At the third month after operation, Qmax was (20.3 卤4.2) ml / s, IPSS was (8.1 卤1.6) / ml / s (1.0 卤0.4), Qmax was (19.6 卤3.7) ml / s and IPSS was (8.4 卤2.3) 卤(1.5 卤0.2) ml / s respectively. 49 cases were followed up for 3-17 months. One case was lost. Among them, 11 cases were cured in X1cm group, and 19 cases were cured or improved in 6 cases of 1cm 鈮，
本文编号：2119716
[Abstract]:Objective: to investigate the clinical efficacy and safety of balloon dilator combined with holmium laser in the treatment of urethral stricture. Methods: 50 patients with urethral stricture were treated with balloon dilator and holmium laser since Feb. 2012. By recording and monitoring the type of urethral stricture, operative time, intraoperative bleeding volume, postoperative complications, postoperative catheter indwelling time, IPSS score and QQL score, maximum uroflow rate (Qmax), cure rate, and so on, statistical analysis was made. To evaluate the curative effect of the surgical treatment of urethral stricture, and summarize the experience of perioperative preparation, operative method, intraoperative matters needing attention, the causes of postoperative complications and the prevention and treatment of postoperative complications. Results: one time operation was successful in 36 patients, the operative time was 20 min-70 min (mean 45.7 卤4.8 min), the blood loss was 5-20 ml (mean 10 ml), the extubation time was 3-29 days (average 20.7 卤4.2 d) after the first extubation, there was no urine retention after the first extubation. Qmax and IPSS were (21.4 卤4.4) ml / s and (8.7 卤2.3) ml / s, respectively (P 0.05). At the third month after operation, Qmax was (20.3 卤4.2) ml / s, IPSS was (8.1 卤1.6) / ml / s (1.0 卤0.4), Qmax was (19.6 卤3.7) ml / s and IPSS was (8.4 卤2.3) 卤(1.5 卤0.2) ml / s respectively. 49 cases were followed up for 3-17 months. One case was lost. Among them, 11 cases were cured in X1cm group, and 19 cases were cured or improved in 6 cases of 1cm 鈮，
本文编号：2119716
本文链接：https://www.wllwen.com/yixuelunwen/mjlw/2119716.html
最近更新
教材专著
