闭合性尿道损伤的临床分析.docVIP

闭合性尿道损伤的临床分析 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：闭合性尿道损伤的临床分析 1 1 一般资料 2 2 治疗方法 2 文2：闭合性尿道损伤的急症处理 5 1 资料与方法 5 2 结 果 6 3 讨 论 6 参考文摘引言： 8 原创性声明（模板） 9 文章致谢（模板） 9 正文 闭合性尿道损伤的临床分析 文1：闭合性尿道损伤的临床分析 Abstract： Objective To explore the diagnosis and treatment of closed urethral The clinical data of 23 cases of closed urethral injuries were retrospectively analyzed, including 9 cases of anterior urethral injuries,10 cases of bulbous urethral injuries, and 4 cases of posterior urethral injuries. Indwelling catheterization, ant-inflammation and hemostasis were performed in 2 cases of urethral contusion and 2 cases of incomplete rupture of 16 cases of incomplete rupture of urethra were treated by surgical operation in which 7 cases were performed by urethral realignment and 7 cases by urethral were 5 cases of complete rupture of urethra, of whom, urethral realignment was performed in 3 cases, urethral anastomoses in 1 case and simple cystostomy in 1 Through drug treatment and operation, satisfactory effects were obtained in 23 patients with less Reasonable therapeutic measurement should be in accordance with the degree and position of urethral injury. Key words:urethral injury;diagnosis;operation 尿道损伤的早期处理对预后有重大意义。回顾性 总结 我院1996～2006年诊治尿道损伤患者23例的体会，现报告如下。 临床资料 1 一般资料 本组23例，男性21岁，女性2例;年龄4～50岁，平均42岁。骑跨伤8例，间接暴力伤(挤压伤，道路 交通 伤，坠落伤)15例。受伤至就诊时间1～12小时，平均3小时。全部病例均有肉眼血尿;仅有尿道口滴血，无排尿困难2例，有排尿困难21例。合并骨盆骨折7例，膀胱破裂1例，股骨骨折1例。根据局部体征，临床症状和检查情况，将损伤程度分为3类：尿道挫伤2例，有血尿，无明显排尿困难;部分断裂伤16例，造影剂检查有外渗，仍保持尿道的连续性;尿道完全断裂伤5例，尿道探子不能进入膀胱，造影剂外渗，尿道分离。尿道损伤部位：前尿道损伤9例，球部损伤10例，后尿道损伤4例。 2 治疗方法 留置导尿3例，尿道会师8例，尿道修补吻合10例，单纯膀胱造瘘2例(见表1)。表1 23例尿道损伤的急诊处理情况 治疗方法尿道损伤部位前尿道损伤球部损伤后尿道损伤尿道损伤程度尿道挫伤部分断裂完全断裂留置导尿201210尿道会师530062尿道修补吻合253091单纯膀胱造瘘020002合计 5 收稿日期：2009-12-25;修回日期：2010-01-26 结 果 23例随访3～13年。3例留置导尿者后未出现排尿异常、尿失禁及阳痿等并发症。8例尿道会师术者中4例出现不同程度的排尿困难而定期行尿道扩张术，2例因尿道扩张无效择期行二次手术治愈，出现尿失禁1例，继发阳痿1例。10例尿道修补吻合术者情况良好，未出现明显的排尿异常、尿失禁及阳痿等并发症。2例膀胱造瘘经断端吻合后治愈，无明显并发症得发生。 讨 论 前尿道损伤主要发生于骑跨伤(钝性伤)，也可发生于穿透伤和医源性损伤。病史、临床表现和体征是