输尿管镜微创术与开放性尿道吻合术治疗尿道损伤临床效果的对比研究

摘要

Objectives:To observe the clinical effects of minimally invasive ureteroscopy and open urethral anastomosis on urethral injury.Methods:40 patients with urethral injury were selected and divided into study group and control group based on different surgical plan after admission.Patients in study group took minimally invasive ureteroscopy while patients in control group took open urethral anastomosis,with 20 cases in each group.Treatment status (surgery time,hospitalization time,bladder irrigation,indwelling catheters and blood loss)and postoperative complications (postoperative bleeding,urethral stricture,erectile dysfunction,urinary fistula,and incontinence), and treatment effects of patients in both groups were observed.Results:The overall efficiency of the study group was 95.0%,while 90.0% in control group,without statistically significant difference (P >0.05).The MFR of the study group was (1 5.1 ±3.6)mL/s,while (1 0.2 ±2.5)mL/s for the control group,with statistically significant difference (P <0.05).Operation time and hospitalization time,and blood loss of the study group are less than con-trol group,with significant difference (P <0.05).The complications,urethral stricture,erectile dysfunction and incontinence of study group were significantly lower than the control group,with statistically significant difference (P<0.05).Conclusion:The effect of minimally invasive ureteroscopy on urethral injury is exact,with fast recovery and fewer complications,which is worth promotion.%目的：观察输尿管镜微创术与开放性尿道吻合术在临床治疗尿道损伤的疗效。方法：临床纳入尿道损伤患者40例，根据入院后手术方案的不同分为研究组与对照组。研究组手术方案选择为输尿管镜微创术，对照组手术方案选择为开放性尿道吻合术，每组20例。观察两组患者治疗情况（包括手术时间、住院时间、膀胱冲洗、留置导管、术中出血等）、术后相关并发症发生情况（包括术后出血、尿道狭窄、勃起障碍、尿瘘、尿失禁等）以及治疗有效率等。结果：研究组患者治疗总有效率为95.0％，对照组患者治疗总有效率为90.0％，差异无显著性（P ＜0.05）。但研究组术后最大尿流率（MFR）为（15.1±3.6）mL／s，对照组术后最大 MFR（10.2±2.5）mL／s，差异有显著性（P ＜0.05）。研究组手术时间、住院时间短于对照组，术中出血少于对照组，差异有显著性（P ＜0.05）。并发症方面，研究组尿道狭窄、勃起障碍、尿失禁的发生率均明显低于对照组，差异有显著性（P ＜0.05）。结论：输尿管镜微创治疗尿道损伤的疗效确切，患者恢复较快，并发症较少，值得推广。