标题：双窥镜下尿道会师术治疗男性尿道损伤的临床价值

      作者：李锋，王飞    (嘉应学院医学院附属医院外科，广东 梅州 514031)

      卷次： 2017年28卷9期

      【摘要】 目的 探讨双窥镜下尿道会师术治疗男性尿道损伤的临床价值，为男性尿道损伤治疗提供参考。方法 选取 2010年 1月至 2015年 1月期间在嘉应学院医学院附属医院住院治疗的 80例男性尿道损伤患者，按照数字表格法随机分为A组和B组，每组40例，A组行输尿管硬镜下尿道会师术治疗，B组行输尿管镜与膀胱镜双窥镜下尿道会师术治疗，观察两组患者的治疗效果和并发症(尿道狭窄、尿失禁、勃起功能障碍)发生情况。结果 A组患者中有6例因损伤严重术中转为开放手术，B组均手术成功；B组患者的手术时间、灌注液体量、术中出血量分别为(26.7±11.5) min、(288.3±40.3) mL、(29.2±12.8) mL，分别短于(少于)A组的(32.2±8.4) min、(320.8±45.9) mL、(35.9±14.9) mL，差异均有统计学意义(P<0.05)；B组患者的手术成功率为 100.0%，明显高于A组的85.0%，差异有统计学意义(P<0.05)；B组患者术后 3个月内并发症发生率为 5.0 %，低于A组的 20.0%，差异有统计学意义(P<0.05)。A组患者的治愈率、好转率分别为70.0%、30.0%，B组分别为90.0%、10.0%，差异均有统计学意义(P<0.05)。结论 双窥镜下尿道会师术治疗男性尿道损伤疗效肯定，较输尿管镜尿道会师术手术成功率高，术后并发症发生率低。
      【关键词】 男性；尿道损伤；输尿管镜；膀胱镜；疗效；并发症
      【中图分类号】 R695 【文献标识码】 A 【文章编号】 1003—6350（2017）09—1418—03

Clinical value of both ureteroscopy and cystoscopy urethral realignment for the treatment of male urethralinjury.
LI Feng, WANG Fei. Department of Surgery, Affiliated Hospital of Medical College of Jiaying University, Meizhou514031, Guangdong, CHINA
【Abstract】 Objective To explore the clinical value of both ureteroscopy and cystoscopy urethral realignmentfor male urethral injury, and provide reference for the treatment of male urethral injury. Methods A total of 80 patientswith urethral injury hospitalized in the Affiliated Hospital of Medical College of Jiaying University from January2010 to January 2015 were investigated. They were divided into A group and B group by a random number table (40cases in each group). A hard ureteroscopy urethral realignment treatment was adopted for A group, and a combinedtype treatment of urethral realignment comprising both ureteroscopy and cystoscopy was adopted for B group. Thetherapeutic effects and complications (urethral stricture, urinary incontinence, erectile dysfunction) of the twogroups were observed. Results In group A, 6 patients with severe injuries converted to open surgery, while ingroup B, all were successful. The operation time，perfusion liquid amount and the intraoperative blood loss in Bgroup were (26.7 ± 11.5) min, (288.3 ± 40.3) mL, and (29.2 ± 12.8) mL, respectively, which were shorter (less) than(32.2±8.4) min, (320.8±45.9) mL, and (35.9±14.9) mL in A group (P<0.05). The success rate of operation in B groupwas 100.0%, which was significantly higher than that in A group (85.0%); the complication rate of B group within 3months after surgery (5.0%) was significantly lower than that in A group (20.0%); and the cure rate and improvementrate of B group were 90.0% and 10.0%, as compared with 70.0% and 30.0% in group A (P<0.05). Conclusions The cu-rative effect of urethral realignment for male urethral injury by using both ureteroscopy and cystoscopy was significant.Compared with ureteroscopy urethral realignment surgery, the combination has a high success rate, and low incidence ofpostoperative complications.
      【Key words】 Male; Urethral injury; Ureteroscopy; Cystoscopy; Curative effect; Complication·论 著·doi:10.3969/j.issn.1003-6350.2017.09.015基金项目：广东省梅州市科技计划项目(编号：2014B126)