双镜下尿道师术32例临床分析.docVIP

双镜下尿道会师术32例临床分析 　　[摘要] 目的 探讨双镜下尿道会师术在治疗骨盆骨折后尿道断裂中的应用价值。 方法 回顾分析32例双镜下尿道会师术治疗骨盆骨折后尿道断裂的临床资料。 结果 本组32例，30例手术成功，2例改为开放手术。手术时间30～58 min，平均（35.0±4.2）min。出血50～100 mL，平均（60.2±5.3）mL。?g后3个月拔除尿管后观察疗效，治愈26例，排尿通畅，无需尿道扩张；好转4例，排尿费力，尿流率下降，经间断、定期尿道扩张后排尿困难症状明显改善，尿流率基本正常，无剩余尿。其中1例术后未按医嘱行定期扩张出现尿道狭窄，行后尿道端端吻合术治愈。随访6～24个月，均排尿正常，最大尿流率13～25 mL/s，平均（20.5±1.0）mL/s，残余尿中国论文网 /6/viewhtm　　[关键词] 后尿道断裂；尿道会师术；软性膀胱镜与硬性输尿管镜 　　[中图分类号] R699 [文献标识码] B [文章编号] 1673-9701（2017）29-0053-03 　　Clinical analysis of 32 cases of urethral reconstruction under dual microscopes 　　LIU Guangquan 　　Department of Urinary Surgery， Zouping County People’s Hospital in Shandong Province， Zouping 256200， China 　　[Abstract] Objective To explore the application value of urethral reconstruction under dual microscopes in the treatment of posterior urethral rupture of pelvic fractures. Methods The clinical data of 32 patients with urethral reconstruction under dual microscopes in the treatment of posterior urethral rupture of pelvic fractures were analyzed retrospectively. Results Among 32 cases in this group， 30 cases had successful surgery， and 2 cases were transferred to open surgery. The surgery time was 30-58 min， with an average of（35.0±4.2） min. Bleeding was 50-100 mL， with an average of （60.2±5.3） mL. 3 months after removal of the urinary catheter， the efficacy was observed. 26 cases were cured， and they had unobstructed stream， with no need for urethral dilatation； 4 cases were improved， they had urination effort， with decreased urine flow rate. After intermittent and regular urethral dilatation， the symptom of dysuria was improved significantly. Urinary flow rate was normal， with no residual urine； one case showed urethral stricture due to the fact that the regular dilatation was not performed according to the doctors advice， and posterior urethral end anastomosis was carried out before being cured. The patients were followed-up for 6-24 months， and all patients had normal urination. The maximum urine flow ra