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目的 探讨后尿道损伤早期安全、合理、有效的治疗方法。 方法 对 2 6 3例后尿道损伤的早期处理进行回顾性分析 ,尿道不全断裂行尿道插管成功 2 1例 ;尿道完全断裂行尿道会师术 (包括会师 +Foley尿管牵引术 ) 178例 ,尿道吻合术 11例 ;病情危重者仅行耻骨上膀胱造瘘术 5 3例。 结果 留置尿管的 2 1例中 ,排尿通畅 18例 ,排尿接近正常 2例 ,失败 1例 ;15 1例 (84.8% )行尿道会师术者得到治愈 ;9例 (81.8% )行尿道吻合术者得到治愈 ;耻骨上膀胱造瘘术者后期均形成尿道闭锁。 结论 后尿道损伤的早期治疗宜根据病人具体情况作出选择。尿道会师术操作简便、创伤小、并发症少 ,可及时恢复尿道的连续性 ,是早期处理后尿道损伤较为合理、有效的首选方法。对病情危重者 ,以耻骨上膀胱造瘘术为宜。
Objective To investigate the safe, reasonable and effective treatment of posterior urethral injury in early stage. Methods A retrospective analysis was performed on the early management of posterior urethral injuries in 263 patients. Twenty-one patients underwent successful urethral intubation with incomplete urethral rupture. One hundred and eighty-eight patients underwent urethronectomy including urethral catheterization and Foley catheterization, Anastomosis in 11 cases; critically ill patients only suprapubic cystostomy 53 cases. Results Of the 21 patients with indwelling ureters, 18 were voided, 2 were normal and 2 were unsuccessful. 15 1 (84.8%) underwent urethral mastectomy and 9 (81.8%) underwent urethral anastomosis Who were cured; suprapubic cystostomy surgery are the formation of urethral atresia. Conclusion The early treatment of posterior urethral injury should be based on the specific circumstances of patients to make a choice. Urethra division technique is simple, less trauma, less complications, urethral continuity can be restored in time, early treatment of urethral injury is more reasonable and effective first choice. In critically ill patients, suprapubic cystostomy is appropriate.