指引法尿道会师术治疗后尿道断裂山西医学院第一附属医院（０３０００１）米振国，刘尚莹，张泓，刘春后尿道断裂是泌尿外科常见急症，多继发于骨盆骨折。早期处理不当，易引起尿道闭锁和狭窄，治疗比较困难。我院自１９８５年７月～１９９２年７月，以指引法尿道会师术治疗后尿道断裂２２例，取得满意效果。现报告如下：临床资料一、一般资料：本组２２例，均系男性，年龄１７～４２岁，平均２７．１岁，因车祸挤压致伤１８例，塌方砸伤４例。就诊时血压测不到者８例，８～６／４～０ｋＰａ８例，１０～８／０～４ｋＰａ４例。骨盆摄片全组病例均有骨盆骨折。其中骨盆粉碎骨折４例，合并股骨干骨折２例，小肠破裂２例，膀胱破裂３例。另有２例合并直肠撕裂伤，尿道断裂处已与外界相通，不宜行会师术治疗者未统计在内，全组病例在纠正休克后均曾以软质导尿管试行导尿。因插管受阻或误入耻骨后间隙引流出新鲜血液，再行直肠指诊发现前列腺飘浮移位、直肠前壁血肿而确诊后尿道断裂。二、治疗方法：本组包括合并小肠破裂、膀胱破裂、股骨干骨折等损伤的７例，在作肠、膀胱修补术后及骨折整复固定等相应处理后，均以指引法尿道会师术进行治疗。指引法尿道会师术是在切开膀胱后，不作任何分离，以右手食指插 Guiding method of urethra will be treated after the treatment of urethral fractures First Affiliated Hospital of Shanxi Medical College (030001) Mi Zhenguo, Liu Shangying, Zhang Hong, Liu Chun posterior urethral rupture is a common emergency urology, mostly secondary to pelvic fractures. Early improper handling, easy to cause urethral atresia and stenosis, the treatment is more difficult. Our hospital from July 1985 to July 1992, guided urethra to treat the posterior urethral rupture in 22 cases, and achieved satisfactory results. Are as follows: Clinical data First, the general information: The group of 22 patients, all men, aged 17 to 42 years old, an average of 27.1 years old, 18 cases of car accident crush injuries, 4 cases of landslide injury. At the time of visit, blood pressure was not detected in 8 cases, 8 ~ 6/4 ~ 0kPa8 cases, 10 ~ 8/0 ~ 4kPa4 cases. Pelvic radiography All patients had pelvic fractures. Among them, 4 cases were comminuted pelvic fracture, 2 cases were complicated with femoral shaft fracture, 2 cases were small intestine rupture and 3 cases were ruptured bladder. Another two cases of rectal laceration, urethral rupture has been connected with the outside world, should not be included in the Association of therapists were not included in the statistics, the whole group of patients after the correction of shock catheterization with soft catheter test. Due to intubation blocked or mistakenly injected into the pubis after the gap drainage of fresh blood, rectal examination of the prostate again found floating shift, rectal anterior hematoma and urethral fracture diagnosis. Second, the treatment: This group includes 7 cases of small intestine rupture, bladder rupture, femoral shaft fractures and other injuries, in the intestine, bladder repair and fracture repair and other appropriate treatment, are guided by the urethra will master treatment. Guiding method of urethra will be mastectomy is cut in the bladder, without any separation, the right index finger inserted