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后尿道断裂的急诊处理

EMERGENCY MANAGEMENT OF POSTERIOR URETHRAL TRAUMA

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【作者】 李湖张永海马汉彬

【Author】 Li Hu Zhang Yonghai Ma Hanbin(Department of Urology, Shantou Central Hospital, Shantou, 515031)

【机构】 广东省汕头市中心医院泌尿外科

【摘要】 目的:为探讨较好的后尿道断裂急诊手术处理方法。方法:对40例后尿道断裂患者分别采用:①单纯膀胱造瘘、Ⅱ期尿道修补,②改进的尿道会师牵引法处理,并对治疗效果进行回顾性总结。结果:单纯膀胱造瘘、Ⅱ期尿道修补5例,术后尿道狭窄3例(60%),并有1例需再次手术,阳萎2例(40%)。采用改进的会师及牵引方法处理35例,32例术后排尿正常,尿道狭窄3例(8.6%);随访26例,阳萎4例(15.4%)。后者术后并发症明显低于前者,疗效也优于未改进的会师加牵引的一些报道。结论:由于会师器械及牵引装置的改进使手术操作方便快捷、疗效佳、并发症减少,改进尿道会师加牵引术通常可作为后尿道断裂急诊手术的首选方法。

【Abstract】 Objective: To explore better surgical approaches in the emergency management of posterior trauma. Methods: A retrospective evaluation of the results of surgical treatment of 40 was done, the patients were devided in two groups, one with simple cystostomy followed by later urethral repair and the other with an improved mode of urethral realignment with tractioin. Results: Simple cystostomy followed by later urethral repair was done in 5 cases, 3(60%) of which had subsequent urethral stricture with one of them receiving reoperation, and 2(40%) of which suffered from impotence. An improved mode of urethral realignment with traction was adopted in the other 35 cases, 3(8.6%) of them had postoprative urethral stricture and the remaining 32 had normal urination. 26 of these cases were followd, with 4(15.4%) of them found to have impotence. In comparison with the former mode, the latter one showed a significantly lower postoperative complication incidence. The therapeutic effects were better than those produced by unimproved urethral alignment with traction found in other reports. Conclusion:Because as the improvement of the apparatus for alignment and traction expedites operations, produces better results and reduces complications, urethral alignment with traction may be the first choice in the emergency surgical management of posterior urethral trauma.

  • 【文献出处】 中山医科大学学报 ,ACADEMIC JOURNAL OF SUN YAT-SEN UNIVERSITY OF MEDICAL SCIENCES , 编辑部邮箱 ,1998年03期
  • 【分类号】R699.6
  • 【被引频次】2
  • 【下载频次】15
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