CAJ | 학술논문

目的：探讨输尿管镜下行尿道会师术治疗尿道断裂的临床效果。方法选取2010年1月至2012年11月本院收治的尿道断裂患者42例。术后诊断前尿道断裂患者22例，后尿道断裂患者20例，且患者均无膀胱破裂、无腹腔内脏损伤。仅有1例患者合并出现不同程度的休克，6例患者伴有下肢骨折。结果42例患者均手术成功。术后4周拔管后36例患者排尿通畅，6例患者经1～6个月常规行尿道扩张术，排尿正常，无尿瘘及尿失禁患者。术后8周检测患者的尿流率，37例患者最大尿流率＞16 ml/s，其余5例患者的最大尿流率为10～16 ml/s。随访3～12个月均排尿正常，无残余尿及勃起功能障碍。结论应用尿道会师术治疗尿道断裂优点：①手术操作相对简单、安全、效果满意；②勃起功能障碍及尿道狭窄等并发症少；③恢复快、住院时间短；④阴茎勃起神经与血管收缩压迫可迅速减轻。由此可见，输尿管镜下行尿道会师术治疗尿道断裂为首选方法，值得临床推广。
목적：탐토수뇨관경하행뇨도회사술치료뇨도단렬적림상효과。방법선취2010년1월지2012년11월본원수치적뇨도단렬환자42례。술후진단전뇨도단렬환자22례，후뇨도단렬환자20례，차환자균무방광파렬、무복강내장손상。부유1례환자합병출현불동정도적휴극，6례환자반유하지골절。결과42례환자균수술성공。술후4주발관후36례환자배뇨통창，6례환자경1～6개월상규행뇨도확장술，배뇨정상，무뇨루급뇨실금환자。술후8주검측환자적뇨류솔，37례환자최대뇨류솔＞16 ml/s，기여5례환자적최대뇨류솔위10～16 ml/s。수방3～12개월균배뇨정상，무잔여뇨급발기공능장애。결론응용뇨도회사술치료뇨도단렬우점：①수술조작상대간단、안전、효과만의；②발기공능장애급뇨도협착등병발증소；③회복쾌、주원시간단；④음경발기신경여혈관수축압박가신속감경。유차가견，수뇨관경하행뇨도회사술치료뇨도단렬위수선방법，치득림상추엄。
ObjectiveTo investigate the treatment of urethral realignment ureteroscopy downstream clinical effects urethral rupture.MethodsFrom January 2010 to November 2012 the hospital admitted 42 patients with urethral rupture. The postoperative diagnosis of urethral rupture in 22 cases, 20 cases of posterior urethral rupture, and the patient had no bladder rupture, no abdominal visceral injury. Only one case of patients with varying degrees of shock performance, 6 patients with lower limb fractures.ResultsOf the 42 patients had successful surgery. After four weeks after surgery, 36 patients extubated urination; six patients patients after 1~6 months of conventional urethral dilation, urination is normal, no urinary ifstula and incontinence patients. 8 weeks after surgery, the patient's urine lfow rate detection, 37 patients maximum lfow rate of greater than 16 ml/s, and the remaining 5 patients, the maximum lfow rate of 10~16 ml/s. 3~12 months of follow-up were normal urination, no residual urine and erectile dysfunction.ConclusionUrethral realignment urethral rupture advantages:①Surgical procedure is relatively simple, safe , satisfactory results;②Erectile dysfunction and urethral stricture fewer complications;③Faster recovery, shorter hospital stay;④Erectile nerves and blood vessels can be oppressed rapidly reduced. It can be seen ureteroscopy downstream urethral realignment is the preferred method of treatment of urethral rupture, worthy of promotion.