摘要目的:探讨经尿道等离子柱状电极与环状电极联合治疗男性后尿道狭窄患者的疗效。方法:回顾性分析2015年3月–2017年4月收治的96例男性后尿道狭窄患者,按手术方法分为等离子柱状电极与环状电极联合治疗组(观察组,51例)和冷刀切开治疗组(对照组,45例),比较两组围术期指标,并随访手术成功率、复发率、再次进行手术率、勃起功能(IIEF-5)评分、最大尿流率(Qmax)及并发症发生率。结果:观察组手术时间(24.27±8.03)min、术中出血量(30.05±4.54)mL明显低于对照组(P<0.01),两组术后住院时间无显著差异(3.84±1.23)d vs. (3.97±1.09)d(P>0.05);观察组手术成功率显著高于对照组(80.39% vs. 53.33%)(P<0.01);观察组复发率(19.61% vs. 46.67%)和再次进行手术率(80.39% vs. 53.33%)均显著低于对照组(P<0.01);观察组IIEF-5评分(16.03±7.49)和Qmax(20.78±5.60)均显著高于对照组(P<0.01);观察组并发症发生率显著低于对照组(3.92% vs. 20.00%)(P<0.05)。结论:经尿道等离子柱状电极与环状电极联合治疗可减少手术时间和出血量,提高手术成功率和最大尿流率,降低复发率和并发症发生率,值得临床推广。
Abstract:Objective: To explore the efficacy of transurethral plasma cylindrical electrode combined with annular electrode in the treatment of male patients with posterior urethral stricture. Methods: Ninety-six male patients with posterior urethral stricture who were admitted to the hospital between March 2015 and April 2017 were divided into the observation group (treated with transurethral plasma cylindrical electrode and annular electrode, n=51) and the control group (treated with cold knife urethrotomy, n = 45) according to the operation method. Perioperative parameters were compared between the two groups. The success rate of surgery, recurrence rate, re-operation rate, erectile function (IIEF-5) scores, maximum flow rate (Qmax) and the incidence of complications were recorded and analyzed retrospectively. Results: The operative time [(24.27±8.03) min] and intraoperative blood loss [(30.05±4.54) mL] in the observation group were significantly reduced as compared with those in the control group (P < 0.01), and there was no significant difference in postoperative hospital stay between the two groups [(3.84±1.23) d vs. (3.97±1.09) d, P > 0.05]. The surgical success rate of the observation group was significantly higher than that of the control group (80.39% vs. 53.33%) (P < 0.01). The recurrence rate of the observation group (19.61% vs. 46.67%) and the reoperation rate (80.39% vs. 53.33%) were significantly lower than those of the control group (P < 0.01). Iief-5 score (16.03±7.49) and Qmax (20.78±5.60) in the observation group were significantly higher than those in the control group (P < 0.01). Conclusion: The combined treatment with transurethral plasma cylindrical electrode and annular electrode can shorten the operation time and reduce the amount of blood loss, improve the success rate of operation and Qmax, and reduce the recurrence rate and the incidence of complications.
罗黔, 吕杰, 王宁, 范微. 等离子体柱状电极联合环状电极腔内治疗男性后尿道狭窄的疗效及安全性分析[J]. 微创泌尿外科杂志, 2020, 9(5): 356-360.
LUO Qian, LYU Jie, WANG Ning, FAN Wei. Efficacy and safety of endovascular treatment with plasma cylindrical electrode and annular electrode for male posterior urethral stricture. JOURNAL OF MINIMALLY INVASIVE UROLOGY, 2020, 9(5): 356-360.
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