中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2011年
11期
728-731
,共4页
宋鲁杰%徐月敏%傅强%撒应龙%张炯%谢弘%金重睿%司捷旻%胡晓勇%李超
宋魯傑%徐月敏%傅彊%撒應龍%張炯%謝弘%金重睿%司捷旻%鬍曉勇%李超
송로걸%서월민%부강%살응룡%장형%사홍%금중예%사첩민%호효용%리초
口腔黏膜%尿道狭窄%颊黏膜%舌黏膜%尿道成形术
口腔黏膜%尿道狹窄%頰黏膜%舌黏膜%尿道成形術
구강점막%뇨도협착%협점막%설점막%뇨도성형술
Mouth mucosa%Urethral stricture%Buccal mucosa%Lingual mucosa%Urethroplasty
目的 探讨口腔内黏膜尿道成形治疗尿道狭窄的长期效果. 方法 2001年1月至2010年12月,应用口腔内黏膜(颊黏膜和舌黏膜)尿道成形治疗前尿道狭窄255例.尿道狭窄段长度3 ～18 cm,平均6 cm.尿道成形采用保留原尿道板的扩大尿道成形术或埋藏黏膜条背侧替代尿道成形术.对49例尿道狭窄段≥8 cm者采取双侧颊黏膜拼接、颊粘膜与舌黏膜拼接或双侧连续长条舌黏膜尿道成形. 结果 术后随访8 ～120个月,平均37个月.230例患者排尿通畅,尿线粗,最大尿流率为16～51 ml/s,平均26 ml/s.尿道造影显示重建段尿道管腔通畅.总成功率90.2％.25例患者于术后1年内发生并发症,其中尿道再次狭窄17例,尿道皮肤瘘8例.17例尿道再狭窄患者中15例再次行口腔内黏膜尿道成形,2例吻合口狭窄行尿道内切开,术后排尿通畅;8例尿道皮肤瘘均接受尿瘘修补术后治愈. 结论 口腔颊黏膜和舌黏膜均是良好的尿道替代物,舌黏膜取材较颊黏膜更为便利;口腔内多种黏膜的组合移植重建尿道是治疗长段前尿道狭窄( ≥8 cm)的有效方法.
目的 探討口腔內黏膜尿道成形治療尿道狹窄的長期效果. 方法 2001年1月至2010年12月,應用口腔內黏膜(頰黏膜和舌黏膜)尿道成形治療前尿道狹窄255例.尿道狹窄段長度3 ～18 cm,平均6 cm.尿道成形採用保留原尿道闆的擴大尿道成形術或埋藏黏膜條揹側替代尿道成形術.對49例尿道狹窄段≥8 cm者採取雙側頰黏膜拼接、頰粘膜與舌黏膜拼接或雙側連續長條舌黏膜尿道成形. 結果 術後隨訪8 ～120箇月,平均37箇月.230例患者排尿通暢,尿線粗,最大尿流率為16～51 ml/s,平均26 ml/s.尿道造影顯示重建段尿道管腔通暢.總成功率90.2％.25例患者于術後1年內髮生併髮癥,其中尿道再次狹窄17例,尿道皮膚瘺8例.17例尿道再狹窄患者中15例再次行口腔內黏膜尿道成形,2例吻閤口狹窄行尿道內切開,術後排尿通暢;8例尿道皮膚瘺均接受尿瘺脩補術後治愈. 結論 口腔頰黏膜和舌黏膜均是良好的尿道替代物,舌黏膜取材較頰黏膜更為便利;口腔內多種黏膜的組閤移植重建尿道是治療長段前尿道狹窄( ≥8 cm)的有效方法.
목적 탐토구강내점막뇨도성형치료뇨도협착적장기효과. 방법 2001년1월지2010년12월,응용구강내점막(협점막화설점막)뇨도성형치료전뇨도협착255례.뇨도협착단장도3 ～18 cm,평균6 cm.뇨도성형채용보류원뇨도판적확대뇨도성형술혹매장점막조배측체대뇨도성형술.대49례뇨도협착단≥8 cm자채취쌍측협점막병접、협점막여설점막병접혹쌍측련속장조설점막뇨도성형. 결과 술후수방8 ～120개월,평균37개월.230례환자배뇨통창,뇨선조,최대뇨류솔위16～51 ml/s,평균26 ml/s.뇨도조영현시중건단뇨도관강통창.총성공솔90.2％.25례환자우술후1년내발생병발증,기중뇨도재차협착17례,뇨도피부루8례.17례뇨도재협착환자중15례재차행구강내점막뇨도성형,2례문합구협착행뇨도내절개,술후배뇨통창;8례뇨도피부루균접수뇨루수보술후치유. 결론 구강협점막화설점막균시량호적뇨도체대물,설점막취재교협점막경위편리;구강내다충점막적조합이식중건뇨도시치료장단전뇨도협착( ≥8 cm)적유효방법.
Objective To evaluate the efficacy of using oral mucosal grafts (buccal mucosa and lingual mucosa) for urethroplasty in the treatment of anterior urethral strictures. Methods Between Jan 2001 and Dec 2010,255 patients with urethral strictures (length ranging from 3 cm to 18 cm,mean 6 cm)underwent one-stage onlay oral mucosal grafts urethroplasty.Two different techniques were used for urethral reconstruction.The first technique involved tubularized dorsal lingual mucosa graft (LMG) augmentation of urethral plate ; the second technique used dorsal patch graft urethroplasty.Of the 255 patients,49 patients with long-segment urethral strictures ( ≥ 8 cm) underwent dual buccal mucosal graft ( BMG),dual LMG,combined LMG and BMG or long-strip LMG urethroplasty. Results The patients were followed up for 8 -120 months postoperatively ( mean 37 months).Of the 255 cases,230 cases voided well and the urinary peak flows ranged from 16 to 51 ml/s (mean 26 ml/s).The overall success rate was 90.2％.Seventeen cases developed a recurrence of urethral stricture.Among these patients,15 underwent BMG urethroplasty again and 2 underwent direct vision internal urethrotomy,after which the patients voided well.Eight cases presented with urethrocutaneous fistula,these patients underwent a second operation,after which,the urethrocutaneous fistulas were cured. Conclusions The buccal mucosa and lingual mucosa are excellent sources of graft materials for the repair of anterior urethral strictures.Combined two oral mucosal grafts substitution urethroplasty is an effective technique for the treatment of long-segment urethral strictures.
