膀胱软镜在骨盆骨折后尿道狭窄患者中的应用及疼痛耐受性研究

发布时间：2018-07-17 21:56

【摘要】：目的研究膀胱软镜在骨盆骨折后尿道狭窄患者中的应用价值并对接受镜检患者的疼痛耐受性情况进行比较分析。方法 120例男性骨盆骨折后尿道损伤(PFUDDs)导致尿道狭窄患者,平均年龄(36.2±9.5)岁(20~58岁)。87例患者接受膀胱软镜检查,33例患者行膀胱硬镜检查,所有患者接受膀胱尿道镜检查完善膀胱、后尿道情况。对膀胱及后尿道结石、膀胱颈部结构异常、后尿道假道、尿道直肠瘘的检查结果与传统的尿道造影检查进行比较分析。依据视觉模拟疼痛评分量表(VAS)对检查中、检查后1天的疼痛情况进行疼痛评分,对膀胱软镜与传统硬镜检查的疼痛评分情况进行分析并比较两组间的差异。结果膀胱软镜检查可以更直观地了解尿道狭窄位置、后尿道结构、膀胱及膀胱内结石等异常情况,通过镜检发现后尿道内结石、膀胱颈部结构异常、后尿道内假道、尿道直肠瘘瘘口分别为21、5、7和5例,与传统的影像学检查异常发现情况比较差异有统计学意义。进行膀胱软镜检查时经尿道及经膀胱造瘘口的疼痛评分明显低于硬镜检查,检查后的延时疼痛评分比较均显示差异有统计学意义。结论对骨盆骨折后尿道狭窄患者进行传统影像学检查的基础上,膀胱软镜检查能提供更全面、更有效的术前评估。患者对检查的疼痛耐受性高,对疾病正确诊治有较高的临床价值,是值得推广的术前检查方法。
[Abstract]:Objective to study the value of soft cystoscopy in patients with posterior urethral stricture of pelvic fracture and to compare the pain tolerance of patients with pelvic fracture. Methods 120 cases of urethral stricture caused by posterior urethral injury (PFUDDs) of male pelvic fractures were studied. The mean age of urethral stricture was (36.2 卤9.5) years old (20 ~ 58 years) .87 cases underwent cystoscopy and 33 cases underwent cystoscopy. Posterior urethra. The results of bladder and posterior urethral calculi, abnormal structure of bladder neck, posterior urethral false passage and urethrorectal fistula were compared with those of traditional urethrography. According to the visual analogue pain scale (VAS), the pain was evaluated one day after the examination, and the difference between the two groups was compared between the soft cystoscopy and the traditional rigid microscope. Results the position of urethral stricture, posterior urethral structure, bladder and intravesical calculi could be more clearly understood by soft cystoscopy. The posterior urethral calculi, bladder neck structure and posterior urethral false passage could be found by cystoscopy. Urethrorectal fistula was found in 7 and 5 cases respectively, which was significantly different from the conventional imaging findings. The pain score of transurethral and transurethral fistula was significantly lower than that of hard endoscopy. Conclusion on the basis of traditional imaging examination in patients with posterior urethral stricture of pelvic fracture, soft cystoscopy can provide more comprehensive and effective preoperative evaluation. The patient has high pain tolerance and high clinical value for correct diagnosis and treatment of the disease. It is worth popularizing the preoperative examination method.
【作者单位】：上海交通大学附属第六人民医院泌尿外科;
【分类号】：R699

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