尿道狭窄冷刀内切开术后粘膜愈合影响因素分析

发布时间：2019-04-12 16:54

【摘要】：研究目的 探讨尿道狭窄冷刀内切开术后尿道粘膜愈合的影响因素，为临床治疗尿道狭窄提供一定的依据。 研究对象和方法 回顾性分析2009年至2011年郑州大学第一附属医院泌尿外科后尿道狭窄住院患者30例，所有患者均为男性，术前均行顺行尿道造影和逆行尿道造影以确定尿道狭窄段长度，均行尿道狭窄冷刀内切开术，术后1月采用导尿管周围造影、尿道镜观察尿道狭窄处愈合情况、测尿流率三种方法，评估尿管留置时间对尿道粘膜愈合情况的影响。 结果 25例(83.3%)导尿管留置时间在12周以上，4例（13.3%）导尿管留置时间在8周以内，1例（3.3%）失败行2次手术治疗，留置时间最短者4周，，最长者20周。以尿流率≥15ml"s为标准，1例于4周后尿流率≥15ml"s；4例于8周后≥15ml"s；24例于12周后≥15ml"s；27例于16周后≥15ml"s；29例于20周后≥15ml"s，差异具有统计学意义（P＜0.001）。随访24个月，排尿正常者20例（66.7%），尿流率均≥15ml"s；排尿基本正常者9例（30%），需半年扩尿道一次；1例（3.3%）拔除导尿管后再次形成狭窄，2次行手术治疗后失访。 结论 1导尿管留置时间和尿道愈合、疗效呈正相关关系 2在积极的控制感染和加强营养的情况下，尿道狭窄冷刀内切开术后拔除导尿管的最佳时间为8~12周左右。而导尿管周围尿道造影、尿道镜检查、尿流率的测定可为导尿管的拔除提供可靠依据。
[Abstract]:Objective to investigate the influencing factors of urethral mucosa healing after cold knife incision for urethral stricture and to provide some evidence for clinical treatment of urethral stricture. Participants and methods A retrospective analysis of 30 inpatients with posterior urethral stricture in the first affiliated Hospital of Zhengzhou University from 2009 to 2011 was carried out, all of which were male. The length of urethral stricture was determined by antegrade urethrography and retrograde urethrography before operation. The length of urethral stricture was determined by cold knife internal incision. One month after operation, urethrography was used to observe the healing of urethral stricture, and the healing of urethral stricture was observed by urethroscopy. Three methods were used to evaluate the effect of indwelling time of catheter on the healing of urethra mucosa. Results 25 cases (83.3%) had catheter indwelling time more than 12 weeks, 4 cases (13.3%) had catheter indwelling time less than 8 weeks, 1 case (3.3%) failed to receive twice operation, and the shortest indwelling time was 4 weeks. A maximum of 20 weeks. According to the criteria of urinary flow rate 鈮

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