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目的探讨膀胱尿道软镜配合筋膜扩张器治疗单纯性尿道狭窄的临床疗效。方法回顾性分析自2008年10月至2010年10月,使用膀胱尿道软镜配合筋膜扩张器治疗80例单纯性尿道狭窄患者的过程。分析患者尿道狭窄类型、术后留置尿管时间、术后并发症及预后,评估该手术方式治疗单纯性尿道狭窄的疗效,并对手术技巧及术后处理进行总结。结果 78例患者一次扩张成功,手术时间7～12 min,平均9 min,无尿道穿孔、尿道撕裂及假道形成等并发症;2例因瘢痕质硬及狭窄段较长扩张失败,最终改行绿激光汽化术治疗。术后随访4～24个月,64例患者随访至今,56例患者经不同次数尿道扩张后,至今排尿情况良好;8例患者因狭窄段瘢痕质硬及扩张后瘢痕缩窄迅速,反复出现尿线变细、排尿困难最终改行绿激光手术治疗。结论膀胱尿道软镜配合筋膜扩张器是治疗单纯性尿道狭窄简单、安全、有效的方法。
Objective To investigate the clinical efficacy of bladder and urethra soft-tissue combined with fascia dilator in the treatment of simple urethral stricture. Methods From October 2008 to October 2010, 80 patients with simple urethral stricture underwent urethral cystoscopy combined with fascia dilator. The type of urethral stricture, postoperative catheterization time, postoperative complications and prognosis were analyzed. The curative effect of this procedure on the treatment of simple urethral stricture was evaluated. The surgical technique and postoperative management were summarized. Results 78 patients were successfully expanded at one time. The operation time ranged from 7 to 12 min, with an average of 9 min. There were no complications such as urethral perforation, urethral tear and false passage formation. Green laser vaporization treatment. All cases were followed up for 4-24 months. Sixty-four patients were followed up till now. Urinary tract excretion was good in 56 patients after urethral dilatation at different times. Eight patients had recurrent urinary incontinence due to scar hardening and rapid constriction of scar after dilatation Line thinning, dysuria eventually switch to green laser surgery. Conclusions Bladder-urethral soft-lens combined with fascia dilator is a simple, safe and effective method for the treatment of simple urethral stricture.