中国临床实用医学
中國臨床實用醫學
중국림상실용의학
CHINA CLINICAL PRACTICAL MEDICINE
2009年
10期
57-58
,共2页
骨盆骨折%后尿道损伤%治疗
骨盆骨摺%後尿道損傷%治療
골분골절%후뇨도손상%치료
Pelvic fractue%Posterior urethral inyure%Treatment
目的 比较骨盆骨折合并后尿道损伤3种手术方式的疗效,为临床选择手术方式提供依据.方法 回顾性总结分析我院1993～2008年15年间36例骨盆骨折合并后尿道损伤的手术方式与随访结果.其中行单纯膀胱造瘘6例,一期尿道吻合术4例,尿道会师牵引术26例,并对其排尿情况与有无阳痿进行分析比较.结果 单纯膀胱造瘘患者均全部出现尿道狭窄式闭锁,发生率100%,需行二期尿道成形术;术后发生阳痿2例,发生率为33%;尿失禁1例.一期尿道吻合术患者,有1例出现轻度尿道狭窄,经数次尿道扩张后治愈,无尿失禁及阳痿.26例尿道会师牵引术患者,有4例发生尿道狭窄,发生率为16%,发生阳痿3例,发生率12%,1例尿失禁.结论 单纯膀胱造瘘患者几乎无例外的均需行二期手术,住院时间长,并发症发生率较高.一期尿道吻合术患者,虽疗效不错,但可选择的病例有限.尿道会师牵引术,手术操作简便,损伤小,疗效好,并发症少,不失为治疗后尿道损伤早期治疗的好方法.
目的 比較骨盆骨摺閤併後尿道損傷3種手術方式的療效,為臨床選擇手術方式提供依據.方法 迴顧性總結分析我院1993～2008年15年間36例骨盆骨摺閤併後尿道損傷的手術方式與隨訪結果.其中行單純膀胱造瘺6例,一期尿道吻閤術4例,尿道會師牽引術26例,併對其排尿情況與有無暘痿進行分析比較.結果 單純膀胱造瘺患者均全部齣現尿道狹窄式閉鎖,髮生率100%,需行二期尿道成形術;術後髮生暘痿2例,髮生率為33%;尿失禁1例.一期尿道吻閤術患者,有1例齣現輕度尿道狹窄,經數次尿道擴張後治愈,無尿失禁及暘痿.26例尿道會師牽引術患者,有4例髮生尿道狹窄,髮生率為16%,髮生暘痿3例,髮生率12%,1例尿失禁.結論 單純膀胱造瘺患者幾乎無例外的均需行二期手術,住院時間長,併髮癥髮生率較高.一期尿道吻閤術患者,雖療效不錯,但可選擇的病例有限.尿道會師牽引術,手術操作簡便,損傷小,療效好,併髮癥少,不失為治療後尿道損傷早期治療的好方法.
목적 비교골분골절합병후뇨도손상3충수술방식적료효,위림상선택수술방식제공의거.방법 회고성총결분석아원1993～2008년15년간36례골분골절합병후뇨도손상적수술방식여수방결과.기중행단순방광조루6례,일기뇨도문합술4례,뇨도회사견인술26례,병대기배뇨정황여유무양위진행분석비교.결과 단순방광조루환자균전부출현뇨도협착식폐쇄,발생솔100%,수행이기뇨도성형술;술후발생양위2례,발생솔위33%;뇨실금1례.일기뇨도문합술환자,유1례출현경도뇨도협착,경수차뇨도확장후치유,무뇨실금급양위.26례뇨도회사견인술환자,유4례발생뇨도협착,발생솔위16%,발생양위3례,발생솔12%,1례뇨실금.결론 단순방광조루환자궤호무예외적균수행이기수술,주원시간장,병발증발생솔교고.일기뇨도문합술환자,수료효불착,단가선택적병례유한.뇨도회사견인술,수술조작간편,손상소,료효호,병발증소,불실위치료후뇨도손상조기치료적호방법.
Objective To compare the results of three surgical treatment of posterior urethral injury associated pelvic fractures so as to povide clcnical basis for selection of treatment of the disese.Methods A retrospective evaluation of the surgical treatment and results of followod up of 36 Patients with posterior urethral injuries after blunt pelvic injrty froom 1993 to 2008.Of all,there were 6 patients patients treated simple suprapubic cyststomy,4 with early open urethroplasty and 26 with early realignment indwelling Foley's catheter was used postoperative for traction.All patients were evaluated postoperatively for abnormal urination and impotence.Results Strictures or atresia developed in 100% of the simple suprapubic.cystostomy group and needed to the second urethroplasty.There had been 2 cases of impotence,the incidence rate was 33%.1 case of urinary incontinence.1 case stricture In the early open urethroplasty group and needed several dilatations.Neither incontinence nor impotence has been observed in this group.26 with early realignment indwelling Foley's catheter,Urethral stricture occarred in 4.and incidence rate was 16%,there had been 3 cases of impotence,the incidence rate was 12%,1 case of incontinence.Conclusion The early realignment indwelling Foley's catheter in simple,effective,nontraumatic and with less occurrence of complication.The technique is therefore recommended for the early surgical management of posterior urethral injure.
