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目的 总结近十年来各种类型尿道损伤的诊治经验。 方法 回顾分析了 134例尿道损伤的临床分型及其诊断和治疗 ,并对其中 6 7例 (4例为女性 )的治疗效果进行了随访。 结果 男性Ⅱ、Ⅲ型损伤和Ⅳ型损伤的术后尿道狭窄的发生率分别为 19% (7/ 36 )和 44 % (12 / 2 7) ,两组差异有显著性意义 (P <0 .0 5 ) ;阳痿的发生率分别为 2 5 % (9/ 36 )和 44 % (12 / 2 7) (P <0 .0 1) ;尿失禁的发生率分别为 0和 11% (3/ 2 7)。对于后尿道损伤者 ,尿道会师术和Ⅱ期尿道端端吻合术术后尿道狭窄的发生率分别为 5 0 % (5 / 10 )和 43% (6 / 14) ,两者之间差异无统计学意义 (P >0 .0 5 )。 结论 Ⅳ型损伤最易引起术后尿道狭窄 ,阳痿的发生率亦较高 ;对于尿道损伤 ,尤其是后尿道 ,应根据不同的损伤类型及伤情而采用不同的处理方法 ;尿道内切开术是治疗创伤性尿道狭窄的理想方法。
Objective To summarize the experience of diagnosis and treatment of various types of urethral injuries in recent ten years. Methods A retrospective analysis of 134 cases of urethral injury in the clinical classification and diagnosis and treatment, and of which 67 cases (4 cases of women) were treated with follow-up. Results The postoperative urethral stricture rate was 19% (7/36) and 44% (12/27) in type Ⅱ and type Ⅲ males respectively. There was significant difference between the two groups (P <0. The incidence of impotence was 25% (9/36) and 44% (12/27), respectively (P0.01). The incidence of urinary incontinence was 0 and 11% (3 / 2 7). For posterior urethral injury, the incidence of urethral stricture was 50% (5/10) and 43% (6/14) respectively after urethral mastectomy and phase Ⅱ urethral anastomosis, the difference was not statistically significant Significance of learning (P> 0.05). Conclusions Type IV injury is the most common cause of postoperative urethral stricture and the incidence of impotence is also high. For urethral injury, especially the posterior urethra, different treatments should be taken according to different types of injuries and injuries. Urethrotomy Is the ideal method of treatment of traumatic urethral stricture.