双窥镜下尿道会师术治疗男性尿道损伤的临床价值

目的 探讨双窥镜下尿道会师术治疗男性尿道损伤的临床价值,为男性尿道损伤治疗提供参考.方法 选取2010年1月至2015年1月期间在嘉应学院医学院附属医院住院治疗的80例男性尿道损伤患者,按照数字表格法随机分为A组和B组,每组40例,A组行输尿管硬镜下尿道会师术治疗,B组行输尿管镜与膀胱镜双窥镜下尿道会师术治疗,观察两组患者的治疗效果和并发症(尿道狭窄、尿失禁、勃起功能障碍)发生情况.结果 A组患者中有6例因损伤严重术中转为开放手术,B组均手术成功;B组患者的手术时间、灌注液体量、术中出血量分别为(26.7±11.5)min、(288.3±40.3)mL、(29.2±12.8)mL,分别短于(少于)A组的(32.2±8.4)min、(320.8±45.9)mL、(35.9±14.9)mL,差异均有统计学意义(P<0.05);B组患者的手术成功率为100.0%,明显高于A组的85.0%,差异有统计学意义(P<0.05);B组患者术后3个月内并发症发生率为5.0%,低于A组的20.0%,差异有统计学意义(P<0.05).A组患者的治愈率、好转率分别为70.0%、30.0%,B组分别为90.0%、10.0%,差异均有统计学意义(P<0.05).结论 双窥镜下尿道会师术治疗男性尿道损伤疗效肯定,较输尿管镜尿道会师术手术成功率高,术后并发症发生率低.

Clinical value of both ureteroscopy and cystoscopy urethral realignment for the treatment of male urethral injury

Objective To explore the clinical value of both ureteroscopy and cystoscopy urethral realignment for male urethral injury, and provide reference for the treatment of male urethral injury. Methods A total of 80 patients with urethral injury hospitalized in the Affiliated Hospital of Medical College of Jiaying University from January 2010 to January 2015 were investigated. They were divided into A group and B group by a random number table (40 cases in each group). A hard ureteroscopy urethral realignment treatment was adopted for A group, and a combined type treatment of urethral realignment comprising both ureteroscopy and cystoscopy was adopted for B group. The therapeutic effects and complications (urethral stricture, urinary incontinence, erectile dysfunction) of the two groups were observed. Results In group A, 6 patients with severe injuries converted to open surgery, while in group B, all were successful. The operation time,perfusion liquid amount and the intraoperative blood loss in B group were (26.7 ± 11.5) min, (288.3 ± 40.3) mL, and (29.2 ± 12.8) mL, respectively, which were shorter (less) than (32.2 ± 8.4) min, (320.8 ± 45.9) mL, and (35.9 ± 14.9) mL in A group (P<0.05). The success rate of operation in B group was 100.0%, which was significantly higher than that in A group (85.0%); the complication rate of B group within 3 months after surgery (5.0%) was significantly lower than that in A group (20.0%);and the cure rate and improvement rate of B group were 90.0%and 10.0%, as compared with 70.0%and 30.0%in group A (P<0.05). Conclusions The cu-rative effect of urethral realignment for male urethral injury by using both ureteroscopy and cystoscopy was significant. Compared with ureteroscopy urethral realignment surgery, the combination has a high success rate, and low incidence of postoperative complications.