中国男科学杂志
中國男科學雜誌
중국남과학잡지
CHINESE JOURNAL OF ANDROLOGY
2014年
11期
25-29
,共5页
丁茂%粘烨琦%易路%李益坚%陈放之%王荫槐
丁茂%粘燁琦%易路%李益堅%陳放之%王蔭槐
정무%점엽기%역로%리익견%진방지%왕음괴
尿道狭窄%组织扩张装置%内窥镜
尿道狹窄%組織擴張裝置%內窺鏡
뇨도협착%조직확장장치%내규경
urethral stricture%tissue expansion devices%endoscopes
目的：探讨肾造瘘球囊扩张器治疗行单纯扩张失败的男性尿道狭窄的有效性及安全性。方法回顾性分析2013年3月至2014年3月使用肾造瘘球囊扩张器治疗狭窄段长度≤2.0cm的39例患者的临床资料。尿道探子扩张失败的39例男性尿道狭窄患者，在尿道镜下置入斑马导丝，沿导丝置入肾造瘘球囊扩张器并定位于狭窄段，退镜后球囊加压扩张尿道，根据患者尿道扩张情况，留置三腔硅胶导尿管（F20~F22）1周，并随访3~12个月。结果37例患者完成扩张，其中5例患者尿道扩张后因尿道狭窄段疤痕较长加用钬激光切除疤痕组织，2例患者改为开放手术。术后第6个月，25例无需再次干预即可顺利排尿，10例患者经过定期金属探子扩张术顺利排尿，2例因再次出现排尿困难转开放治疗。术后6个月，最大尿流率（Qmax）0.5~1.0cm狭窄段为17.1ml/s（15.2~25.4 ml/s, n=17），1.1~1.5cm狭窄段为16.8 ml/s（15.2~24.9 ml/s, n=7），1.5~2.0cm狭窄段为15.5ml/s（n=1）。所有患者均无假道形成、尿道穿孔及尿道热等严重并发症。结论尿道镜下联合肾造瘘球囊扩张器治疗窄段≤1.5cm且单纯扩张失败的尿道狭窄安全、有效，操作简单，具有较好的治疗效果。
目的：探討腎造瘺毬囊擴張器治療行單純擴張失敗的男性尿道狹窄的有效性及安全性。方法迴顧性分析2013年3月至2014年3月使用腎造瘺毬囊擴張器治療狹窄段長度≤2.0cm的39例患者的臨床資料。尿道探子擴張失敗的39例男性尿道狹窄患者，在尿道鏡下置入斑馬導絲，沿導絲置入腎造瘺毬囊擴張器併定位于狹窄段，退鏡後毬囊加壓擴張尿道，根據患者尿道擴張情況，留置三腔硅膠導尿管（F20~F22）1週，併隨訪3~12箇月。結果37例患者完成擴張，其中5例患者尿道擴張後因尿道狹窄段疤痕較長加用鈥激光切除疤痕組織，2例患者改為開放手術。術後第6箇月，25例無需再次榦預即可順利排尿，10例患者經過定期金屬探子擴張術順利排尿，2例因再次齣現排尿睏難轉開放治療。術後6箇月，最大尿流率（Qmax）0.5~1.0cm狹窄段為17.1ml/s（15.2~25.4 ml/s, n=17），1.1~1.5cm狹窄段為16.8 ml/s（15.2~24.9 ml/s, n=7），1.5~2.0cm狹窄段為15.5ml/s（n=1）。所有患者均無假道形成、尿道穿孔及尿道熱等嚴重併髮癥。結論尿道鏡下聯閤腎造瘺毬囊擴張器治療窄段≤1.5cm且單純擴張失敗的尿道狹窄安全、有效，操作簡單，具有較好的治療效果。
목적：탐토신조루구낭확장기치료행단순확장실패적남성뇨도협착적유효성급안전성。방법회고성분석2013년3월지2014년3월사용신조루구낭확장기치료협착단장도≤2.0cm적39례환자적림상자료。뇨도탐자확장실패적39례남성뇨도협착환자，재뇨도경하치입반마도사，연도사치입신조루구낭확장기병정위우협착단，퇴경후구낭가압확장뇨도，근거환자뇨도확장정황，류치삼강규효도뇨관（F20~F22）1주，병수방3~12개월。결과37례환자완성확장，기중5례환자뇨도확장후인뇨도협착단파흔교장가용화격광절제파흔조직，2례환자개위개방수술。술후제6개월，25례무수재차간예즉가순리배뇨，10례환자경과정기금속탐자확장술순리배뇨，2례인재차출현배뇨곤난전개방치료。술후6개월，최대뇨류솔（Qmax）0.5~1.0cm협착단위17.1ml/s（15.2~25.4 ml/s, n=17），1.1~1.5cm협착단위16.8 ml/s（15.2~24.9 ml/s, n=7），1.5~2.0cm협착단위15.5ml/s（n=1）。소유환자균무가도형성、뇨도천공급뇨도열등엄중병발증。결론뇨도경하연합신조루구낭확장기치료착단≤1.5cm차단순확장실패적뇨도협착안전、유효，조작간단，구유교호적치료효과。
Objective To investigate the efficacy and safety of urethral dilatation with nephrostomy balloon dilation catheter in the treatment of male patients with urethrostenosis failing to be dilated by bougienage.Methods Clinical date of 39 cases of male patients with urethrostenosis (length of stricture less than 2.0)treated by nephrostomy balloon dilation catheter were analysed retrospecively (2013.03 to 2014.03). Thirty-nine male patients with failure of bougienage treatment received rethral dilatation with nephrostomy balloon dilation catheter. Under the urethroscopy,a zebra -guide wire was inserted through the strictured urethra into the bladder,then the nephrostomy balloon dilation catheter was inseted along the zebra-guide wire and put the catheter on the right place of the stenosis, gradually dilated with nephrostomy balloon dilation catheter after drawing out the urethroscopy, followed by placing a Foley catheter(F20-F22)for 1 weeks.All the patients were followed up for 3-12 months.Results The operation was success in 37 cases, holmium laser was used to excise scar tissue after dilation in 5 cases, 2 patients received stricture resection and end-to-end anastomosis. 25 of the patients were cured without any redilation and operation, 10 patients have relatively normal urination after dilation by bougienage for several times and 2 patients received stricture resection and end-to-end anastomosis for stricture recurrence. After 3 months,the maximum flow rate was 0.5-1.0cm group: 17.1ml/s (15.2-25.4 ml/s,n=17), 1.1~1.5cm group:16.8 ml/s (15.2~24.9 ml/s, n=7), 1.5-2.0cm group:15.5ml/s (n=1). All patients had no urethral false passage, urethral perforation or urethral fever.Conclusion Urethral dilatation with nephrostomy balloon dilation catheter under the urethroscopy is a simple,safe and effective treatment with fewer complications and high success rate on urethrostenosis with the length of stricture less than 1.5 cm and failure of bougienage treatment.
