腔内钬激光内切开术治疗创伤性后尿道狭窄疗效观察

摘要

Objective To observe the clinical significance of transurethral holmium laser incision operation in treatment of traumatic posterior urethral stricture. Methods A total of 34 patients with traumatic posterior urethral stric-ture, who were treated in our hospital from May 2013 to May 2015, were selected as research objects. According to the different operations, all the patients were divided into observation group and control group, with 17 cases in each group. The observation group was treated by transurethral holmium laser incision, and the control group was treated by the traditional open surgery. The clinical curative effect and complications after the treatment in both groups was ob-served. Results The surgeries were performed smoothly in two groups. The operation time, blood loss, recovery time of gastrointestinal tract, length of hospital stay and hospital costs of observation group were significantly lower than those in the control group [(54.6 ± 26.8) min vs (214.2 ± 87.9) min, (30.1 ± 11.8) mL vs (231.7 ± 54.9) mL, (12.9 ± 5.1) h vs (21.2±5.3) h, (4.6±2.9) d vs (13.7±4.2) d, (12693±3106) yuan vs (17368±3927) yuan, P<0.05]. The overall complica-tion incidence in the observation group (41.2%) was significantly lower than the control group (82.4%), P<0.05. The dif-ferences of the relapse rate between observation group (23.5%) and control group (11.8%) were not statistically signifi-cant (χ2=2.0142, P>0.05). Conclusion Transurethral holmium laser incision has better clinical curative effect in the treatment of traumatic posterior urethral stricture than traditional surgery. It is safe, effective, minimally invasive, with rapid recovery and other advantage, which worth spreading in clinical practices.%目的 观察腔内钬激光内切开术治疗创伤性后尿道狭窄的临床疗效.方法 选取2013年5月至2015年5月我院收治的创伤性后尿道狭窄患者34例,按照手术方式不同将其分为观察组与对照组,每组17例.观察组采取腔内经尿道钬激光内切开术,对照组采取传统开放性手术,比较两组患者治疗后的临床疗效及并发症情况.结果 两组患者的手术均顺利完成;观察组的手术时间、出血量、胃肠道恢复时间、住院时间及住院费用分别与对照组比较均明显降低[(54.6±26.8)min vs(214.2±87.9)min、(30.1±11.8)ml vs(231.7±54.9)ml、(12.9±5.1)h vs(21.2±5.3)h、(4.6±2.9)d vs(13.7±4.2)d、(12693±3106)元vs(17368±3927)元],差异均具有统计学意义(P<0.05);观察组术后并发症总发生率为41.2%,明显低于对照组的82.4%,比较差异具有统计学意义(P<0.05);对照组患者复发率为11.8%,观察组患者复发率为23.5%,两组间比较差异无统计学意义(χ2=2.0142,P>0.05).结论 腔内钬激光内切开术治疗创伤性后尿道狭窄的临床疗效较好,其具有安全、有效、创伤小、恢复快等优势,值得临床推广应用.