骨盆骨折合并后尿道断裂22例临床诊疗分析

目的总结骨盆骨折合并后尿道断裂的诊疗经验。方法回顾总结骨盆骨折合并后尿道断裂22例患者的诊疗资料、手术方法与治疗结果。结果12例I期行尿道会师术；6例急诊行耻骨上膀胱穿刺造瘘术，Ⅱ期行后尿道吻合术；4例I期行后尿道吻合术；12例I期行尿道会师术后病人中，其中4例因瘢痕性尿道狭窄，Ⅱ期行后尿道吻合术2例，Ⅱ期行后尿道拖入术2例。术后22例患者均恢复满意。结论骨盆骨折合并后尿道断裂的患者表现病情轻重不一，应结合患者的生命体征等情况，根据个体化原则选择合适的手术方式治疗。

Diagnosis and treatment of 22 cases of posterior urethral rupture complicated with pelvic fracture

Objective To summarize the experience of diagnosis and treatment for posterior urethral rupture complicated with pelvic fracture. Methods The clinical data, surgical method and treatment results of 22 eases of posterior urethral rupture complicated with pelvic fracture were reviewed and summarized. Results Twelve eases of underwent phase I urethral realignment ,6 eases of under- went phase II emergeney suprapubic cystostomy and posterior urethral anastomosis, and 4 eases of underwent phase I posterior ure- thral anastomosis. Among 12 eases of undergoing phase I urethral realignment ,4 eases suffered from urethral stricture because of the scarring, of which 2 cases received phase ]I posterior urethral anastomosis and another 2 eases received posterior urethral pull - through technique. After surgery,22 patients had a satisfactory recovery. Conclusion The manifestion of posterior urethral injury complicated with pelvic fracture vary from person to person, therefore suitable surgical methods should be adopted according to individual vital signs.