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目的探讨后尿道损伤的早期处理方法。方法回顾性总结65例后尿道损伤的临床资料。结果①16例为不完全性尿道断裂伤,13例顺利插入F12-16号导尿管治愈,3例伴休克及合并其他器官伤行膀胱造瘘术;②49例为完全性尿道断裂伤,其中24例行Ⅰ期尿道吻合术,术后均排尿通畅;17例行改良尿道会师牵引固定术,即膀胱颈会阴部贯穿牵引固定术,术后15例(85.7%)排尿通畅,2例(14.3%)尿道狭窄再次手术切除尿道瘢痕;8例伴休克和合并其他器官损伤行膀胱造瘘术,在伤后3～6个月行尿道成形术,术后6例排尿正常,2例在术后1～2个月出现尿线变细,经3～6次尿道扩张后排尿恢复正常。结论尿道不完全性断裂伤且病情稳定,能够顺利经尿道外口插入导尿管者,就不必要进行其他手术;病情稳定、无合并其他器官损伤者,首选Ⅰ期尿道吻合术或膀胱颈会阴部贯穿牵引固定术;病情欠稳定及合并其他器官损伤者则选择膀胱造瘘术,以保证患者生命安全。
Objective To investigate the early treatment of posterior urethral injury. Methods The clinical data of 65 cases of posterior urethral injury were retrospectively reviewed. Results ①16 cases of incomplete urethral rupture, 13 cases were successfully inserted into the F12-16 catheter cure, 3 cases with shock and other organ injury and cystostomy; 49 cases of complete urethral rupture, of which 24 Routine stage I urethral anastomosis, postoperative urination were smooth; 17 cases of improved urethral traction traction fixation, the perineal neck through the traction fixation, postoperative 15 cases (85.7%) voiding, 2 cases (14.3% ) Urethral stricture reoperation to remove the urethral scar; 8 cases with shock and other organ damage underwent cystostomy, 3 to 6 months after injury urethroplasty, postoperative urination in 6 cases normal, 2 cases after 1 ~ 2 months, the urine becomes thinner, after 3 to 6 urethral dilatation urination returned to normal. Conclusion The urethra incomplete rupture and stable condition, can be successfully inserted into the catheter through the urethral orifice, it is unnecessary for other operations; stable condition, without complications of other organs, the first phase urethral anastomosis or bladder neck will Pudendal traction fixation; disease is not stable and other organ damage combined with the selection of bladder ostomy to ensure patient safety.