实用临床医学
實用臨床醫學
실용림상의학
Practical Clinical Medicine
2014年
2期
42-46
,共5页
尿道狭窄%钬激光%冷刀%汽化电切%比较研究
尿道狹窄%鈥激光%冷刀%汽化電切%比較研究
뇨도협착%화격광%냉도%기화전절%비교연구
urethral stricture%holmium laser%cold knife%electrovaporization%comparison
目的：探讨钬激光、冷刀内切和汽化电切治疗尿道狭窄的临床效果。方法将79例尿道狭窄患者按手术治疗方法的不同分为3组，钬激光组（30例，采用内镜下钬激光切除术治疗）、冷刀组（26例，采用冷刀内切开治疗）和汽电组（23例，采用汽化电切治疗）。对3组患者的近期观察指标（手术时间、术中出血量以及住院时间）和远期观察指标（术后最大尿流率、术后尿道扩张时间、再次手术例数及患者对治疗满意度）进行比较。结果近期观察效果：3组患者均一次性顺利完成手术。钬激光组手术时间显著高于冷刀组与汽电组，出血量低于冷刀组与汽电组（均P＜0.05）；3组住院时间比较差异均无统计学意义（P＞0.05）。远期观察效果：3组患者在术后均获6个月～3年的随访，平均（1.8±0.8）年。钬激光组术后最大尿流率、术后尿道扩张时间、再次手术例数及患者对治疗满意度情况等观察指标均优于汽电组及冷刀组（均P＜0.05）。结论内镜下钬激光切除术治疗尿道狭窄与冷刀切开术和汽化电切术比较均具有明显的优势，是一种治疗尿道狭窄疗效更好，可靠性、安全性更高的的理想方法。
目的：探討鈥激光、冷刀內切和汽化電切治療尿道狹窄的臨床效果。方法將79例尿道狹窄患者按手術治療方法的不同分為3組，鈥激光組（30例，採用內鏡下鈥激光切除術治療）、冷刀組（26例，採用冷刀內切開治療）和汽電組（23例，採用汽化電切治療）。對3組患者的近期觀察指標（手術時間、術中齣血量以及住院時間）和遠期觀察指標（術後最大尿流率、術後尿道擴張時間、再次手術例數及患者對治療滿意度）進行比較。結果近期觀察效果：3組患者均一次性順利完成手術。鈥激光組手術時間顯著高于冷刀組與汽電組，齣血量低于冷刀組與汽電組（均P＜0.05）；3組住院時間比較差異均無統計學意義（P＞0.05）。遠期觀察效果：3組患者在術後均穫6箇月～3年的隨訪，平均（1.8±0.8）年。鈥激光組術後最大尿流率、術後尿道擴張時間、再次手術例數及患者對治療滿意度情況等觀察指標均優于汽電組及冷刀組（均P＜0.05）。結論內鏡下鈥激光切除術治療尿道狹窄與冷刀切開術和汽化電切術比較均具有明顯的優勢，是一種治療尿道狹窄療效更好，可靠性、安全性更高的的理想方法。
목적：탐토화격광、냉도내절화기화전절치료뇨도협착적림상효과。방법장79례뇨도협착환자안수술치료방법적불동분위3조，화격광조（30례，채용내경하화격광절제술치료）、냉도조（26례，채용냉도내절개치료）화기전조（23례，채용기화전절치료）。대3조환자적근기관찰지표（수술시간、술중출혈량이급주원시간）화원기관찰지표（술후최대뇨류솔、술후뇨도확장시간、재차수술례수급환자대치료만의도）진행비교。결과근기관찰효과：3조환자균일차성순리완성수술。화격광조수술시간현저고우냉도조여기전조，출혈량저우냉도조여기전조（균P＜0.05）；3조주원시간비교차이균무통계학의의（P＞0.05）。원기관찰효과：3조환자재술후균획6개월～3년적수방，평균（1.8±0.8）년。화격광조술후최대뇨류솔、술후뇨도확장시간、재차수술례수급환자대치료만의도정황등관찰지표균우우기전조급냉도조（균P＜0.05）。결론내경하화격광절제술치료뇨도협착여냉도절개술화기화전절술비교균구유명현적우세，시일충치료뇨도협착료효경호，가고성、안전성경고적적이상방법。
Objective To compare the efficacies of holmium laser, cold knife incision and electrova-porization in the treatment of urethral stricture.Methods Seventy-nine patients with urethral stricture were treated with endoscopic holmium laser resection (holmium laser group,n=30),cold knife incision (cold knife group,n=26)or electrovaporization (electrovaporization group,n=23).Compare to recent ob-servation effect (operation time,intraoperative blood loss,and the length of time )and long-term observa-tion effect(the maximum urinary flow rate and postoperative urethral expansion time,mode and again pa-tient satisfaction)of three groups patients.Results All operations were successfully completed at the first attempt. Compared with holmium laser group, operation time was shortened and blood loss was in-creased in cold knife group and electrovaporization group(all P<0.05). There were no significant differ-ences in hospital stay among the three groups(P>0.05). After 6 months to 3 years of follow-up(average, 1.8±0.8 years),maximum urinary flow rate, urethral dilation time, reoperation number and patient sat-isfaction with treatment were significantly improved in holmium laser group, compared with cold knife group and electrovaporization group (all P<0.05).Conclusion Endoscopic holmium laser resection is more reliable and safer than cold knife incision and electrovaporization for treating urethral stricture.
