CAJ | 학술논문

目的：探讨经尿道双极等离子电切治疗男性尿道狭窄的临床疗效。方法选取2010年10月～2013年1月采用双极等离子电切治疗尿道狭窄男性患者37例，年龄16-77岁。平均35.5岁。病程6个月～10年，平均1.5年。其中尿道骑跨伤21例，骨盆骨折11例，留置导尿管后出现尿道狭窄3例，前列腺电切术后膀胱颈部狭窄2例，前尿道狭窄24例，后尿道狭窄13例，狭窄长度0.5～2.0 cm，平均1.1 cm。结果37例手术均成功，术中无尿道穿孔、假道形成等发生，所见瘢痕被全部清除，手术时间15-55min，平均(33.3±10.2)min；创面无严重出血，出血量10-25ml，平均(14.9±4.9)ml。尿管均保留2-4周后拔除，均能自主排尿，排尿通畅，未见尿道大量出血、尿瘘，最大尿流率Qmax18～25ml/s。全部随访3个月-2年，有4例失访(10.8％)，余下33例每周定期行尿道扩张，2例出现尿失禁，经提肛锻炼后3个月内逐渐恢复，有2例再发狭窄而行2次手术，其余28例排尿正常。结论经尿道双极等离子电切治疗男性尿道狭窄是治疗尿道狭窄的一种安全的、有效的方法。
목적：탐토경뇨도쌍겁등리자전절치료남성뇨도협착적림상료효。방법선취2010년10월～2013년1월채용쌍겁등리자전절치료뇨도협착남성환자37례，년령16-77세。평균35.5세。병정6개월～10년，평균1.5년。기중뇨도기과상21례，골분골절11례，류치도뇨관후출현뇨도협착3례，전렬선전절술후방광경부협착2례，전뇨도협착24례，후뇨도협착13례，협착장도0.5～2.0 cm，평균1.1 cm。결과37례수술균성공，술중무뇨도천공、가도형성등발생，소견반흔피전부청제，수술시간15-55min，평균(33.3±10.2)min；창면무엄중출혈，출혈량10-25ml，평균(14.9±4.9)ml。뇨관균보류2-4주후발제，균능자주배뇨，배뇨통창，미견뇨도대량출혈、뇨루，최대뇨류솔Qmax18～25ml/s。전부수방3개월-2년，유4례실방(10.8％)，여하33례매주정기행뇨도확장，2례출현뇨실금，경제항단련후3개월내축점회복，유2례재발협착이행2차수술，기여28례배뇨정상。결론경뇨도쌍겁등리자전절치료남성뇨도협착시치료뇨도협착적일충안전적、유효적방법。
Objective To investigate the clinical efficacy of transurethral plasmakinetic resection in treating urethral stricture.of male. Methods From October 2010 to January 2013, 37 patients with urethral stricture were treated by transurethral plasma kinetic resection, aged from 16 to 77 years, the average aged was 35.5 years. The course of disease from 6 months to 10 years, averaged 1.5 years. Among them, urethral straddle injury, urethral stricture caused by pelvic fracture, bladder neck stricture after resection of prostate, anterior urethral stricture, posterior urethral stricture were in 21,11,3,2,24,13 cases respectively. the length of stricture was 0.5~2.0 cm, averaged 1.1 cm. Results Al of the cases were treated successful y, there was no urethral perforation and no false passage formation occurred during the operation,. the scar was al removed, the time of operation was 15-55 minutes, mean (33.3±10.2) minutes; there was no sever bleeding, the volume of intra operative bleeding was 10 to 25 ml, mean (14.9±4.9)ml. The catheter would be pul off after 2-4 weeks, al patients were urinary unobstructed. there was no sever bleeding in urethra and no urinary fistula, The maximum flow rates were 18~25ml per second. With fol ow-up from 3 to 24months, 4 patients were lost to fol ow-up (10.8%), The left 33 cases with transurethral plasma kinetic resection were expanded weekly. urinary incontinence were found in 2cases, they returned gradual y after the training of tightening sphincter within 3 months .recurrences of urethral stricture was found in 2 cases during fol ow -up period ,and had the second operation. the left 28 cases had normal urination. Conclusion The transurethral plasma kinetic resection in treating the male urethral stricture is safe and effective.