ALA-PDT对兔耳增生性瘢痕抑制效应及作用机制的初步研究

目的：观察ALA-PDT（5-氨基酮戊酸光动力疗法）对兔耳增生性瘢痕形成的抑制作用及对转化生长因子β1（TGF-β1）表达的影响。方法：在兔耳腹侧面做直径1cm大小全层皮肤缺损创面3个/侧,共60个。随机分为以下三组：高浓度ALA-PDT组（n=20）：20%ALA介导PDT治疗;低浓度ALA-PDT组（n=20）：10%ALA介导PDT治疗;对照组（n=20）：不做治疗,待创面自然愈合。在创面形成术后的第6天、第13天分别进行ALA-PDT治疗,观察治疗组与对照组之间的瘢痕形成率、瘢痕增生指数、胶原纤维含量及TGF-β1表达情况的差异。结果：ALA-PDT治疗降低了瘢痕形成率,其中药物高浓度ALA-PDT组与对照组的差异有统计学意义（P〈0.01）;药物高浓度ALA-PDT组和药物低浓度ALA-PDT组的瘢痕增生指数、胶原纤维含量与对照组的差异有统计学意义（P〈0.05）;药物高浓度ALA-PDT组与对照组之间的TGF-β1的表达差异具有统计学显著性（P〈0.05）。结论：ALA-PDT对兔耳增生性瘢痕的形成有抑制作用,从而预防创伤后增生性瘢痕形成,该作用可能通过减少TGF-β1的产生而实现。     

尿道瘢痕组织的病理学研究

目的：探讨尿道瘢痕的病理学特点。方法：收集手术切除的尿道狭窄段瘢痕组织以及脑死亡患者的正常尿道组织各10例，作为研究标本。分别对研究标本行苏木精-伊红染色、胶原纤维染色、弹力纤维染色、粘多糖染色及Ⅰ型、Ⅲ型胶原的免疫组化染色。结果：尿道瘢痕以大量致密的纤维结缔组织代替海绵体组织，二者互相交错，无明显分界；细胞外基质中胶原纤维增多，弹性纤维减少，并伴有较多的粘多糖沉积。尿道瘢痕和正常尿道的Ⅰ型：Ⅲ型比值分别为5．68，3．65。结论：尿道瘢痕的病理学特点与其僵直性、非依从性的特点一致，并与其治疗效果不佳有关。     

电针抑制兔耳增生性瘢痕形成的作用研究

目的：探究电针刺激在抑制兔耳增生性瘢痕形成过程中的影响。方法：以成年新西兰雄性兔（24只）为实验对象,随机分为电针组、手针组、模型组、空白组,除空白组外其余各组在兔耳腹侧面造成创面以形成瘢痕组织,然后根据组别分别在血海与翳风穴给予不同的刺激,比较各组兔耳增生性瘢痕形成情况,测定增生性瘢痕的瘢痕增生指数、各样品组织中羟脯氨酸的含量及胶原纤维的排列。结果：电针治疗组的瘢痕增生指数与其他各组存在明显差异（P〈0．05）,HE染色在光镜下可见胶原纤维组织排列整齐度的增加及胶原纤维组织含量的降低。结论：电针可以抑制兔耳增生性瘢痕形成。     

外用细菌纤维素影响兔耳创面愈合的形态学及组织学观察

目的：观察细菌纤维素（BC）对创面愈合的影响。方法：应用新西兰大耳白兔18只,随机分成空白对照（A组）、BC（1∶5）实验（B组）、BC（1∶6）实验（C组）、BC（1∶8）实验（D组）、纳米银对照（E组）、油纱对照（F组）,建立兔耳皮肤创面愈合模型,通过不同时间点观察创面愈合的形态学及组织学变化。结果：①形态学观察：实验（B、C、D）组能够有效促进兔耳创面愈合,对照组间疗效并无显著区别;②HE染色：创面愈合期（0～14天）同一时间点,实验组的毛细血管和肉芽组织生长较对照组丰富;③Masson三色法胶原染色：对照（A、E、F）组创面的胶原纤维稍粗大,排列稍紊乱;B、C、D实验组创面的胶原纤维较细,排列较整齐;④免疫组化染色：α-SMA特异性阳性表达的程度为：D组〉B组〉C组〉A组〉E组〉F组。结论：BC能有效促进创面愈合,减轻瘢痕形成,且细菌纤维素（1∶8）组是促进创面愈合的最适敷料治疗组。     

曲安奈德注射和电子线照射及手术治疗兔耳瘢痕的研究

目的 观察采用生理盐水、曲安奈德、手术、电子线照射等治疗对兔耳增生性瘢痕的形态学影响,探寻治疗瘢痕的最优方案.方法 建立兔耳腹侧增生性瘢痕模型.随机分为空白组（A组）、生理盐水组（B组）、手术加生理盐水组（C组）、曲安奈德组（D组）、手术加曲安奈德组（E组）、电子线组（F组）、手术后2d电子线组（G组）、手术后7d电子线组（H组）,通过HE染色、VG染色、甲苯胺蓝染色、CD34和α-SMA免疫组织化学行组织形态学观察.结果 胶原纤维观察显示：A、B组,D、G组,F、H组差异无统计学意义（P＞0.05）,其余各组两两比较差异有统计学意义（P＜0.05）.甲苯胺蓝染色发现肥大细胞不典型.微血管观察显示：A、B组,F、H组,G、H组差异无统计学意义（P＞0.05）,其余各组两两比较差异有统计学意义（P＜0.05）.成肌纤维细胞观察显示：A、B组差异无统计学意义（P＞0.05）,其余各组两两比较差异有统计学意义（P＜0.05）.结论 曲安奈德注射治疗兔耳瘢痕效果优于电子线放疗,电子线术后早期放疗效果优于愈合后放疗,曲安奈德、电子线联合手术治疗效果优于单一治疗.     

兔耳病理性瘢痕皮回植术后组织中基质金属蛋白酶－1及金属蛋白酶组织抑制剂－1表达的变化

目的通过建立兔耳模型观察基质金属蛋白酶－1（matrixmetalloproteinase－1,MMP－1）及金属蛋白酶组织抑制剂－1（tissueinh｜bitorofmetalloproteinase1,TIMP1）在病理性瘢痕皮回植术后组织中表达的变化,探讨瘢痕皮回植治疗病理性瘢痕的机制。方法建立兔耳病理性瘢痕模型。共分为3组：正常皮肤组（对照组,A组）、病理性瘢痕组（B组）及瘢痕皮回植组（c组）。切取标本行HE染色和Masson特殊组织化学染色及免疫组织化学染色,观察各组标本MMP－1、TIMP－1的表达情况。结果病理性瘢痕经瘢痕皮回植术后,MMP－1及TIMP－l均较A组明显升高（P〈O．01）．MMP一1的表达较TIMP一1明显增强（P〈O．01）。结论瘢痕皮回植术治疗瘢痕的机制与瘢痕组织内MMP一1和TIMP一1相互作用的失衡有关。     

反义结缔组织生长因子抑制兔耳增生性瘢痕的作用

目的探讨反义结缔组织生长因子（connective tissue grouth factro,CTGF）对兔耳增生性瘢痕的抑制作用。方法选择20只大耳白兔建立增生性瘢痕动物模型,随机分成5组,对照组为A组,注射转化生长因子β1（TGF-β1）为B组,注射CTGF为C组,先后注射TGF-β1和CTGF为D组,注射反义CTGF为E组,每个治疗组又分为治疗7、14、20d3组;通过逆转录-聚合酶链式反应（RT-PCR）方法检测增生性瘢痕中CTGF mRNA的表达,免疫组织化学检测CTGF蛋白表达,HE、Masson染色观察切片内成纤维细胞数密度,计算机辅助图像分析测算切片内胶原纤维面密度。结果E组中CTGF mRNA、蛋白表达、成纤维细胞数密度和胶原纤维面密度均降低,与A、B组比较,差异有统计学意义（P〈0.05）。结论反义CTGF可以抑制兔耳增生性瘢痕的增殖过程,使瘢痕组织纤维化程度明显减轻。     

芪蛭降糖胶囊对糖尿病肾病大鼠肾组织BMP-7及TGF-β1/smads信号传导通路的影响

目的：观察芪蛭降糖胶囊对糖尿病肾病（diabetic nephropathy,DN）大鼠肾组织骨形成蛋白-7（bone morpho-genetic protein-7,BMP-7）及转化生长因子（transforming growth factor,TGF）-β1/Smads信号传导通路的影响。方法：48只清洁级雄性Wistar大鼠按体重随机抽取40只,采用切除右肾加腹腔注射链脲菌素（ streptozotocin,STZ）的方法制备DN模型,另外8只大鼠行右肾假切术。造模成功后按尿微量白蛋白（ microAlbumin,mAlb）高低,两头随机抽取分为模型组、缬沙坦对照组、芪蛭降糖胶囊低剂量组、芪蛭降糖胶囊高剂量组。成模2 d起各组给予相应浓度和剂量的药物,给药12周时观察DN大鼠尿mAlb、α1微球蛋白（α1-MG）和血清肌酐（ Scr）、尿素氮（ BUN）。然后,处死所有动物,肾组织行HE染色、PAS染色和Masson染色,观察肾组织病理变化并半定量计算肾小管损伤指数（tubulointerstitial injury index,TII）,免疫组化法检测BMP-7、TGF-β1、Smad2、Smad7在肾组织的表达。结果：给药12周后,模型组大鼠尿 mAlb、α1-MG较假手术组显著增多（ P 〈0.01）,3个治疗组DN大鼠尿mAlb、α1-MG较模型组明显减少（P〈0.01）,2个中药治疗组的上述4项指标亦较对照组降低（P〈0.05-0.01）,且呈剂量依赖性。模型组大鼠Scr、BUN亦较假手术组显著升高（P〈0.01）,对照组与模型组相比无明显变化（P〉0.05）,但2个中药治疗组较模型组明显降低（P〈0.05-0.01）。 HE染色显示,3个治疗组大鼠肾组织病理损害明显减轻,2个中药治疗组大鼠肾组织病理改善比对照组更明显;PAS染色进行TII评分发现,3个治疗组大鼠TII显著低于模型组（P〈0.01）,2个中药治疗组TII明显低于对照组（P〈0.05-0.01）;Masson染色观察发现,3个实验组大鼠肾小管间质病变明显轻于模型组,2个中药治疗组大鼠肾小管间质病变轻于对照组;免疫组化法染色并对其灰度值测定发现,3个治疗组大鼠TGF-β1、Smad2在肾组织的表达低于模型组（P〈0.01）,2个中药治疗组大鼠TGF-β1、Smad2在肾组织的表达低于对照组（P〈0.05-0.01）;3个治疗组大鼠BMP-7、Smad7在肾脏组织的表达高于模型组（P〈0.01）,2个中药治疗组大鼠BMP-7、Smad7在肾组织的表达高于对照组（P〈0.05-0.01）。结论：芪蛭降糖胶囊可能通过干预BMP-7/TGF-β1/Smads信号转导通路抑制了TGF-β1信号的细胞内转导,而对DN肾间质纤维化起到治疗作用。     

经尿道绿激光瘢痕汽化与尿道狭窄内切开及电切术治疗尿道狭窄的疗效比较

目的比较经尿道绿激光瘢痕汽化与尿道狭窄内切开及电切术治疗尿道狭窄的疗效。方法分析33例经尿道绿激光瘢痕汽化（A组）和41例尿道狭窄内切开及电切术（B组）治疗尿道狭窄的临床资料。比较两组手术时间、住院时间、手术有效率、并发症的发生率、术后最大尿流率、术后尿道扩张次数的差异。结果两组间的手术时间、手术有效率和术后最大尿流率差异无统计学意义（P〉0．05）,但A组住院时间、手术并发症的发生率、术后尿道扩张的次数显著少于B组fP〈0．05）。结论经尿道绿激光瘢痕汽化优于尿道狭窄内切开及电切术治疗尿道狭窄。     

经尿道绿激光汽化和经尿道电切治疗表浅性膀胱肿瘤疗效的对比观察

目的比较经尿道绿激光汽化与经尿道电切治疗表浅性膀胱肿瘤的疗效及安全性。方法随机选取35例（实验组）膀胱肿瘤患者行经尿道绿激光汽化术，另32例（对照组）行经尿道电切术，观察两组术中、术后并发症及复发情况。结果两组平均手术时间、保留导尿管时间、术后肿瘤复发率差异均无统计学意义（P〉0．05），实验组术中出血量及术后膀胱冲洗时间明显少于对照组（P〈0．05）。同时膀胱穿孔和闭孔神经反射仅在对照组中发生。结论选择性绿激光汽化术是治疗膀胱肿瘤安全有效的方法，具有创伤小、出血少、恢复快及并发症发生率低等特点，尤其适用于侧壁表浅性膀胱肿瘤。     

Urethral replacement: a comparison between small intestinal submucosa grafts and spontaneous regeneration

OBJECTIVE: To evaluate the use of commercially available single-layer small intestinal submucosa (SIS) for urethral replacement, both as an onlay and as a tube, in a rabbit model. MATERIALS AND METHODS: Thirty-six male rabbits were assigned to four experimental groups. Group 1 had the ventral wall of the penile urethra excised for 15 mm; in group 2 this created defect was patched with a SIS onlay graft; group 3 had complete excision of a 15 mm segment of the penile urethra; and in group 4, this created defect was replaced with a SIS tube graft. In all rabbits the urethra was stented for 2 weeks. A retrograde urethrogram was taken in all rabbits before death at 3, 6 and 12 weeks after surgery. The urethra was then exposed, examined carefully and excised for histopathological examination. RESULTS: In groups 1 and 2 the retrograde urethrograms were normal in 13 rabbits and there was relative narrowing in two rabbits in group 1 and three in group 2. In groups 3 and 4 all rabbits developed urethral fistulae or strictures. Histological examination of the urethra showed epithelial regeneration supported by smooth muscle backing in all rabbits in group 1, while rabbits in group 2 showed no regeneration of smooth muscle. By contrast, rabbits in groups 3 and 4 showed incomplete regeneration and progressive fibrosis. CONCLUSIONS: Single-layer SIS is not a suitable urethral substitute in this animal model. When used as an onlay, healing is inferior to spontaneous urethral regeneration, as SIS impedes smooth muscle cell regeneration. When used as a tube, there is complete scarring and urethral luminal occlusion.     

生物可降解性尿道内支架修复战伤性尿道狭窄的研究

目的建立战伤性尿道狭窄动物模型,探讨生物可降解性尿道内支架对其进行重建修复的可行性。方法将新西兰雄兔28只分为两组,实验组(n=20):以定位爆炸法建立尿道狭窄模型。一月后行逆行尿道造影、尿道镜检查,并切除狭窄段尿道,行病理组织学观察证实。后置入人工合成生物可降解尿道内支架,置入术后2、4、8、12周分别行逆行尿道造影、尿道镜检查以及尿流动力学检测。并在以上各时间点处死5只动物,取狭窄处尿道组织,观察组织学修复重建情况。对照组(n=8):于实验组爆炸处理后4周和支架置入12周,分别取对照组4只动物与实验组对比观察。结果实验组所有动物爆炸后4周在尿道球部狭窄形成稳定狭窄模型(狭窄段长5～10 mm,尿道腔缩窄50%以上)。尿道内支架置入后2周,组织学观察见黏膜上皮新生迹象,并有炎性细胞浸润;4周时上皮新生明显,炎性细胞消失;8周时出现尿道平滑肌细胞再生,12周时见损伤后尿道组织结构完全修复,与正常尿道组织比较差异无统计学意义(P>0.05)。。同时间点尿道镜检查证实尿道腔隙、黏膜形态结构无异于正常对照组。尿流动力学检测显示两组间差异无统计学意义(P>0.05)。。结论应用成功建立的战伤性尿道狭窄动物模型,证实生物可降解性尿道内支架能作为修复战伤性尿道狭窄的理想材料,具有损伤小,易操作,功能恢复快的特点。     

Histopathological evaluation of the urethra after the Snodgrass operation: an experimental study in rabbits

OBJECTIVE: To investigate the histopathological outcome of the incised urethral plate after tubularized incised-plate urethroplasty (the Snodgrass procedure to repair hypospadias) in a hypospadiac rabbit model, as it can produce meatal and neourethral strictures, and healing with scarring. MATERIALS AND METHODS: The study comprised 10 male New Zealand White rabbits (2.2-2.4 kg); under general anaesthesia the ventral urethra was completely excised 1 cm from the meatus proximally and a model of hypospadias formed. A full-thickness incision was then made in the distal dorsal urethra and the two sides of the incision marked by Indian ink tattooing. After placing a feeding tube (5 F) as a urethral catheter, both urethral wings were sutured ventrally by a 7/0 polydioxanone running suture, and the penile skin approximated by 5/0 chromic catgut. At 21 days and 3 months after surgery the penises were harvested, assessed histopathologically, and compared with those from control untreated rabbits of the same age and weight. RESULTS: In the study group the incised area of the dorsal urethra was re-epithelialized; the regional tissue and vascularity were normal. CONCLUSION: In this rabbit model the dorsal urethral incisions healed with no scar tissue; only the ventral suture lines had minimal fibrosis and inflammatory reaction.     

尿道会师导引装置在尿道狭窄与闭锁的腔内手术中的应用：附视频

目的 探索在治疗尿道狭窄与闭锁的腔内手术中应用尿道会师导引装置的可行性和安全性.方法 深圳市第八人民医院自2008年1月至2012年8月,对25例后尿道狭窄和闭锁患者行腔内切开手术,其中11例应用尿道会师导引杆置入后尿道指引金属导丝穿刺通过瘢痕尿道,在导丝引导下行尿道腔内狭窄切开和瘢痕切除术,术后留置导尿管3～6周,拔管后行定期尿道扩张,现对其临床资料行回顾性分析.结果 25例腔内手术均一次成功,无中转开放手术.手术时间35～86 min,术中出血量5～25ml.20例拔尿管后排尿正常,5例排尿不畅,拔管后扩张尿道4～12次后排尿正常,出院1个月后复查尿流率,最大尿流率（Qmax）为（16.0±3.5） ml/s.术后无一例尿失禁.结论 将尿道会师导引装置应用于治疗尿道闭锁和狭窄的腔内手术中有利于引导金属导丝跨越尿道瘢痕,操作安全可靠,简便易行.     

经尿道等离子电切镜治疗尿道狭窄

目的 总结提高经尿道等离子电切镜治疗瘢痕性尿道狭窄的手术成功率并预防狭窄再发的经验. 方法 回顾2008年3月～ 2011年6月应用等离子电切镜治疗尿道狭窄20例的临床资料. 结果 手术时间平均(33.3±10.8)min;平均出血量(11.9 ±4.9)ml;术中尿道均顺利通过26F电切镜;术后留置尿管1～2个月;拔管后定期尿道扩张.17例获3月～3年随访,5例再发狭窄,3例仍在扩张治疗中,9例排尿正常. 结论 尿道狭窄内镜手术要切除瘢痕,松解尿道达25 ～26F;术后留置尿管要与尿道正常内径相近,拔管时间根据狭窄长度决定;保留尿管期间注意膀胱过度活动症的防治.     

口腔黏膜细胞与膀胱黏膜下脱细胞基质复合物构建组织工程化尿道的实验研究

目的 探讨以兔口腔黏膜细胞与同种异体膀胱黏膜下脱细胞基质(BAMG)复合物构建组织工程化尿道的可行性.方法 新西兰雄性兔24只,距尿道外口2.0 cm剥离尿道黏膜(2.0 cm×0.8 cm)后,随机分实验组和对照组,每组12只.切取实验组兔口腔黏膜组织分离细胞,在有灭活的3T3细胞培养皿上进行培养扩增,将培养获得的第2代口腔黏膜细胞种植于BAMG(2.2 cm×1.0 cm)上,植入实验组兔尿道缺损区域;对照组单纯采用无细胞植入的BAMG修复尿道.分别于术后1、2、6个月观察动物排尿情况,行尿道造影,8 F尿管插管确定有无狭窄;随后处死实验兔,取修复段尿道黏膜组织行组织学检查.结果 细胞培养获得的口腔黏膜细胞形态均一,生长良好;组织形态学、扫描电镜观察见口腔黏膜细胞与BAMG具有良好的相容性.实验组兔术后1、2、6个月伤口愈合良好、排尿通畅,无尿瘘发生,组织学和尿道造影检查显示带细胞修复的尿道形态完整、清晰宽敞,无狭窄发生;术后6个月植入的口腔黏膜细胞仍然存在,并明显扩增.对照组兔则出现排尿困难、尿道狭窄,光镜下发现黏膜及黏膜下存在严重的炎症反应.结论 兔口腔黏膜细胞与同种异体BAMG复合后,可成功用于尿道缺损的修复,构建组织工程化尿道.     

自制导光尿道探子在治疗男性创伤性尿道狭窄或闭琐中的应用

目的：探讨自制导光尿道探子联合输尿管镜及电切镜在治疗男性创伤性尿道狭窄或闭锁中的作用和价值。方法：采用自制导光尿道探子及输尿管镜置入斑马导丝通过尿道狭窄或闭锁部位进入膀胱,再经斑马导丝引导筋膜扩张器扩裂尿道狭窄或闭锁部位,电切尿道瘢痕组织,留置F20硅胶尿管4周。采用此方法治疗创伤性尿道狭窄或闭琐患者27例。结果：21例尿道狭窄患者经输尿管镜置入斑马导丝成功,6例尿道闭锁患者通过自制导光尿道探子建立通道,由输尿管导管引导置入斑马导丝成功。扩裂及电切治疗27例手术均获得成功,恢复正常排尿,其中2例尿道再狭窄者行尿道扩张治愈。结论：自制导光尿道探子联合输尿管镜及电切镜治疗男性创伤性尿道狭窄或闭锁操作简单、安全、有效,损伤小,并发症少,住院时间短,是一种理想的术式。     

Curative effect and histocompatibility evaluation of reconstruction of traumatic defect of rabbit urethra using extracellular matrix

Objective： To investigate the curative effect and histocompatibility of reconstruction of traumatic urethral defect of rabbit using urethral extracellular matrix （ECM）.
Methods： Urethral ECM was obtained by excision of the urethra in 20 donor rabbits. In experimental group, 20 rabbits were resected a 1.0 cm-1.5 cm segment of the urethra and artificially made a model of traumatic urethral defect, then reconstructed by the urethral extracellular matrix of the same length. The rabbit immunity response was assessed by lymphocyte transformation test and serum TNF- α level. The reconstructed urethral segments were stained with hematoxylin-eosin and Van Gieson stain and observed by histological examination postoperatively. The urethrography, urethroscopy and urodynamic examinations were performed.
Results： There was no significant difference in stimulative index of lymphocyte transformation between ECM group and control group. The serum TNF- α levels of ECM group slightly rose, but the increase was not significant as compared with control group. On postoperative day 10, epithelial cell had migrated from each side and small vessels were found in the extracellular matrix. In the 3rd week, several layers of urothelium covered the whole surface of the matrix tube. In the 6th week, the disorganized arrangements of smooth muscle fibers were firstly observed by Van Gieson staining. In the 24th week, the smooth muscle cells increased and the matrix tube appeared fairly similar to normal urethral wall components. The urethroscopy and urodynamic evaluation revealed that the surface of reconstructed urethra was smooth and emiction was unobstructed.
Conclusion： The urethral extracellular matrix might be an ideal and safe biomaterial for the reconstruction of urethral traumatic defect.     

Biochemical analysis of urethral collagen content after tubularized incised plate urethroplasty: an experimental study in rabbits

The aim of the present study was the biochemical analysis of tissue hydroxyproline levels in incised urethral plates in order to show the total collagen content after the Snodgrass operation in the hypospadiac rabbit model. The study comprised 21 male New Zealand rabbits, (2.2–2.4 kg). The animals were randomly allocated to three groups each containing seven rabbits as follows: group 1, the ventral urethra was completely excised and a model of hypospadias formed. A full-thickness incision was made on the distal dorsal urethra, a feeding tube was placed as an urethral catheter and both urethral wings were sutured ventrally. Group 2, inserting an iris knife into the urethra, the ventral wall was incised mimicking an urethrotome. Group 3 consisted of normal control rabbits to determine the basal tissue hydroxyproline level. A slight increase in the hydroxyproline level was observed in the ventral part of the urethral tissue compared to the dorsal part in both groups 1 and 2; however, these differences were not significant. After the Snodgrass operation in the rabbit model, no significant differences were observed in the hydroxyproline levels of the dorsal and ventral parts of the urethra or between these and of the controls. Further studies are required in order to determine the mechanism underlying urethral healing through normal re-epithelization without excess collagen deposition after incised urethral plate urethroplasty.     

快速冷冻切片在尿道端端吻合术中的应用价值

目的：探讨快速冷冻切片在后尿道端端吻合术中的应用价值。方法：对102例临床确诊为后尿道闭锁的患者随机分成两组进行后尿道端端吻合术。A组46例，将瘢痕组织切除，依据术者经验判断为尿道黏膜组织后行后尿道端端吻合术；B组56例，吻合前用快速冷冻切片证实为尿道黏膜后行后尿道端端吻合术。两组患者均于术后3周拔除导尿管，并比较两组患者的术后疗效。结果：A组患者的手术成功率为74％（34／46），B组患者的手术成功率为93％（52／56）。结论：快速冷冻切片可避免因术者经验所致的手术缺陷，科学准确的指导操作，提高手术成功率。