本文關鍵詞： 等離子電切 復雜性后尿道狹窄　出處：《青海大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的通過對比經尿道等離子電切及開放手術在治療復雜性后尿道狹窄中的臨床療效，評價兩種手術方式的臨床價值，為復雜性后尿道狹窄治療的手術方式選擇提供依據。 方法選擇2010年1月至2013年1月期間，于青海省人民醫(yī)院泌尿外科住院治療的80例復雜性后尿狹窄患者，其中40例患者應用等離子電切治療（為等離子電切組），其余40例患者采用經會陰尿道狹窄段切除術加端端吻合術（為開放手術組）。術后隨訪12月，收集兩組患者臨床資料，進行統(tǒng)計學分析，對比兩組的臨床療效。 結果等離子電切手術組和開放手術組手術時間分別為142.2±17.1min、75.1±6.2min，手術中出血量分別為426.0±61.3ml、15.8±6.9ml，術后住院時間分別為13.1±1.6d、9.1±1.5d，術后行尿道擴張的總次數分別為17.2±5.7次、7.5±4.1次，術后第3月復查最大尿流率分別為17.3±3.6ml／s、17.1±4.0ml／s。開放手術組34例患者治愈，6例失敗，治愈率85%；等離子電切組35例治愈，5例失敗，治愈率87.5%。失敗患者表現為尿線細，尿道造影顯示后尿道再次狹窄，予以定期尿道擴張后能改善排尿，無需再次手術治療。開放手術組術后并發(fā)癥包括1例尿失禁和勃起功能障礙1例，，等離子體柱電極加電切組無術后并發(fā)癥發(fā)生。 結論1.相對于開放手術，等離子電切擁有手術操作簡便快捷、并發(fā)癥少、損傷小、愈合快的特點，可作為未并發(fā)尿道憩室及尿瘺的復雜性后尿道狹窄的治療首選。 2.兩組的術后尿道擴張次數均隨時間的延長，呈逐漸減少的趨勢，以術后3月內最為頻繁，相同時間段內，等離子電切手術可明顯減少術后尿道擴張的頻率及次數，可有效的減輕患者的痛苦。
[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 鹵17.1 min and 75.1 鹵6.2 min, respectively. The amount of bleeding during operation was 426.0 鹵61.3ml / L 15.8 鹵6.9ml, respectively, and the postoperative hospitalization time was 13.1 鹵1.6days (9.1 鹵1.5d). The total times of urethral dilatation were 17. 2 鹵5. 7 times and 7. 5 鹵4. 1 times, respectively. The maximum flow rate was 17. 3 鹵3. 6 ml / s on March. 17.1 鹵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.
【學位授予單位】：青海大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R699

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