分析应用两种手术方法治疗尿道损伤后果的效果

G. Khodzhamuradov, S. S. Ziyozoda, K. Rizoev, M. Ismoilov, M. B. Sharipova, A.KH. Tolibov
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摘要

目的:分析两种手术技术在尿道损伤后遗症治疗中的应用效果。方法:对38例年龄16.4±1.9岁的崔氏综合征患者进行分析。CUI定位于舟骨窝(n=3),阴茎部分(n=9),球根区(n=6)。多尿道病变8例,全尿道病变12例。其他研究方法包括膀胱超声检查、尿流测定、残余尿量测定,必要时还包括逆行和排尿尿道造影。采用口腔黏膜瓣进行一期(16例,第一组)和二期(22例,第二组)尿道成形术。通过上行尿道造影和尿流术评估手术结果。随访时间为6 ~ 24个月。结果:两组近期疗效和远期疗效均有显著性差异。根据尿流测量数据,手术干预有效性的主要指标是最大尿流率稳定保持至少15ml /sec。第一组有1例早期创面裂开伴瘘道形成。第二组8例出现早期分化,并伴有瘘管形成。这些并发症需要额外的手术干预;他们的纠正被推迟了。结论:口腔黏膜瓣一期尿道成形术治疗崔氏综合征比二期手术更安全、更有效。关键词:尿道损伤后果、尿道造影、尿流测量、口腔瓣。
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ANALYSIS OF THE EFFICIENCY OF APPLICATION OF THE TWO SURGERY METHODS OF TREATMENT OF THE URETHRAL INJURY CONSEQUENCES
Objective: To analyze the results of application of the two surgical techniques in the treatment of the consequences of urethral injuries (CUI). Methods: 38 patients aged 16.4±1.9 years with CUI were examined. CUI were localized in the area of the scaphoid fossa (n=3), the penile part (n=9), the bulbous region (n=6). Multi-site and panurethral lesions were noted in 8 and 12 cases, respectively. Additional research methods included ultrasound examination of the bladder, uroflowmetry, residual urine measurement, and, if necessary, retrograde and voiding urethrography. The patients underwent two types of surgical intervention: one-stage (16 patients, 1st group) and two-stage (22 patients, 2nd group) urethroplasty using a buccal mucosal flap. The results of surgery were assessed by ascending urethrography and uroflowmetry. The follow-up period ranged from 6 to 24 months. Results: The immediate and long-term results between the two groups showed significant difference. According to uroflowmetry data, the main indicator of the effectiveness of surgical intervention was a stable retention of maximum urine flow rate at least 15 ml/sec. In the 1st group, there was one case of early wound dehiscence with the formation of a fistula. In the 2nd group, early divergence was observed in 8 cases, it was also accompanied by formation of fistulas. These complications required additional surgical intervention; their correction was deferred. Conclusion: One-stage urethroplasty using a buccal mucosal flap for CUI proved to be safer and more effective compared to the two-stage technique Keywords: Consequences of urethral injury, urethrography, uroflowmetry, buccal flap.
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