介入尿道会师术治疗男性尿道断裂.docVIP

介入尿道会师术治疗男性尿道断裂【摘要】目的：探讨用介入方法对尿道断裂的患者行急诊尿道会师治疗。方法 对17例骨盆骨折和骑跨伤伴尿道断裂患者，采用经尿道外口送入超滑导丝，或经耻骨上膀胱穿刺置入导管鞘，自导管鞘送入超滑导丝，送至尿道外口；不能通过者通过尿道外口送入抓捕器,将导丝自尿道外口抓出。沿导丝送入尿管，行尿道会师牵引术，通过随访l、3、6、12个月至3年。结果 术后3～4周拔除导尿管，17例患者中5例患者出现尿道狭窄，术后3例使用尿道金属探子扩张，2例使用球囊扩张尿道，保留导尿管3～4周，随访1～3年患者均自行排尿通畅。结论 介入尿道会师术，操作简便，创伤小，并发症少，可重复操作，康复快等优点。 【关键词】介入；尿道会师术；尿道断裂 The interventional urethra re alignment for treating urethral disruption Zhao shi-jun Zhu zhi-guo Gao jing-chun 【Abstract】 ObjectiveTo explore the clinical efficacy of interventional urethra re alignment for treating urethral disruption.Methods In 17 cases of urethral disruption complicated pelvic fracture or straddle injure, the guide wire were inserted from urethra external meatus through rupture site into the bladder or penetrated bladder by anterograde inserted guide wire through the injure side out of external meatus, Snare could be used for parts of them which couldn?tpass the disruption, and the foley catheter were inserted into the bladder along wire. ResultsAll patients were sussessfully performed. The catheters were removed after 3～4 weeks.There were 5 patients（5/17） with stenosis, three patients were dilataed by metal urethra probe and two patients by balloon, the foley catheter were retained for 3～4. Follewed by 1～3 years, there weren’t patients with restenosis. ConclusionsThe interventional urethra re alignment is effective for treating urethral disruption with less operation time and invation, and the operation can be repeated. 【Key words】Intervational; urethra re alignment; urethral disruption 【中图分类号】R699.1【文献标识码】B【文章编号】1008-6455（2011）08-0163-01 我院自2004年9月至2010年10月，对17例尿道断裂患者，急诊介入（在C型臂引导）下行尿道会师术，随访1―2年，效果满意，报告如下。 1 资料及方法 1.1 临床资料:本组病例共17例，年龄在22－64岁之间，平均年龄35岁。均为男性。致伤原因：车祸11例，骑跨伤6例。其中尿道球部不完全断裂4例，完全断裂2例；尿道膜部部分损伤3例，完全断裂8例。伴骨盆骨折11例，阴囊和会阴血肿4例，休克4例。伤后患者16例不能自行排尿，17例均行留置导尿失败。直肠指检，前列腺有浮动感，下腹及会阴部有不同程度淤血和尿外渗。 1.2 材料与方法 1.2.1 材料选择:单弯导管：美国强生生产；超滑导丝：日本TERUMO公司生产的带亲水涂层的黑泥鳅导丝，直径0.035（约0.89mm）；导管鞘：包括穿刺针，鞘管，支撑器，J形导丝，美国C