本文選題：尿道狹窄或閉鎖 + μm激光　； 參考：《微創(chuàng)泌尿外科雜志》2013年05期

【摘要】：目的:探討經(jīng)尿道2μm激光尿道內(nèi)切開術治療外傷性尿道狹窄與閉鎖的治療效果。方法:50例外傷性后尿道斷裂行恥骨上膀胱造瘺術和尿道會師術后再次尿道狹窄或閉鎖患者,均經(jīng)術前積極準備后采用2μm激光直視下尿道內(nèi)切開術治療,最大尿流率(MFR)、國際前列腺癥狀評分(IPSS)、生活質(zhì)量評分(QOL)作為評價手術效果的3個指標,分別于術前、術后拔除尿管、出院3個月后復查所測得。并行統(tǒng)計學分析。結果:50例患者經(jīng)積極術前準備后均采用2μm激光直視下尿道內(nèi)切開術治療,術中均無直腸損傷、尿瘺形成、大出血等,術后留置尿管2~4周,拔除尿管后,最大尿流率從術前的(2.7±0.8)ml/s改善為(15.7±2.1)ml/s,3個月后復查平均最大尿流率為(16.1±2.1)ml/s,IPSS評分從術前的(28.7±5.1)分改善為術后拔除尿管時的(10.2±5.4)分,術后3個月時的(8.8±5.4)分,QOL從術前的(5.7±0.5)分改善為術后拔管時的(2.1±1.7)和術后3個月時的(1.8±1.7)分,47例患者拔除尿管后尿道狹窄沒有復發(fā),3例患者復發(fā)尿道狹窄,其中1例術后拔除尿管1周出現(xiàn)尿失禁,50例患者撥除尿管后均按原則定期擴尿道,必要時膀胱鏡下擴尿道治療,配合排尿鍛煉后全部改善。結論:經(jīng)尿道2μm激光尿道內(nèi)切開術是治療外傷性尿道狹窄或閉鎖的一種適宜的好方法。
[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 鹵0.8)ml/s to 15. 7 鹵2. 1 ml / s. After 3 months, the average maximum flow rate was 16. 1 鹵2. 1 鹵2. 1 ml / sIPSS score from 28. 7 鹵5. 1 before operation to 10. 2 鹵5. 4 at the time of extubation. The QOL at 3 months after operation was improved from 5.7 鹵0.5) to 2.1 鹵1.7 at extubation and 1.8 鹵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.
【作者單位】： 山西醫(yī)科大學研究生院;山西醫(yī)學科學院山西大醫(yī)院泌尿外科;
【分類號】：R699

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