【摘要】：目的研究膀胱軟鏡在骨盆骨折后尿道狹窄患者中的應(yīng)用價(jià)值并對(duì)接受鏡檢患者的疼痛耐受性情況進(jìn)行比較分析。方法 120例男性骨盆骨折后尿道損傷(PFUDDs)導(dǎo)致尿道狹窄患者,平均年齡(36.2±9.5)歲(20~58歲)。87例患者接受膀胱軟鏡檢查,33例患者行膀胱硬鏡檢查,所有患者接受膀胱尿道鏡檢查完善膀胱、后尿道情況。對(duì)膀胱及后尿道結(jié)石、膀胱頸部結(jié)構(gòu)異常、后尿道假道、尿道直腸瘺的檢查結(jié)果與傳統(tǒng)的尿道造影檢查進(jìn)行比較分析。依據(jù)視覺模擬疼痛評(píng)分量表(VAS)對(duì)檢查中、檢查后1天的疼痛情況進(jìn)行疼痛評(píng)分,對(duì)膀胱軟鏡與傳統(tǒng)硬鏡檢查的疼痛評(píng)分情況進(jìn)行分析并比較兩組間的差異。結(jié)果膀胱軟鏡檢查可以更直觀地了解尿道狹窄位置、后尿道結(jié)構(gòu)、膀胱及膀胱內(nèi)結(jié)石等異常情況,通過鏡檢發(fā)現(xiàn)后尿道內(nèi)結(jié)石、膀胱頸部結(jié)構(gòu)異常、后尿道內(nèi)假道、尿道直腸瘺瘺口分別為21、5、7和5例,與傳統(tǒng)的影像學(xué)檢查異常發(fā)現(xiàn)情況比較差異有統(tǒng)計(jì)學(xué)意義。進(jìn)行膀胱軟鏡檢查時(shí)經(jīng)尿道及經(jīng)膀胱造瘺口的疼痛評(píng)分明顯低于硬鏡檢查,檢查后的延時(shí)疼痛評(píng)分比較均顯示差異有統(tǒng)計(jì)學(xué)意義。結(jié)論對(duì)骨盆骨折后尿道狹窄患者進(jìn)行傳統(tǒng)影像學(xué)檢查的基礎(chǔ)上,膀胱軟鏡檢查能提供更全面、更有效的術(shù)前評(píng)估�；颊邔�(duì)檢查的疼痛耐受性高,對(duì)疾病正確診治有較高的臨床價(jià)值,是值得推廣的術(shù)前檢查方法。
[Abstract]:Objective to study the value of soft cystoscopy in patients with posterior urethral stricture of pelvic fracture and to compare the pain tolerance of patients with pelvic fracture. Methods 120 cases of urethral stricture caused by posterior urethral injury (PFUDDs) of male pelvic fractures were studied. The mean age of urethral stricture was (36.2 鹵9.5) years old (20 ~ 58 years) .87 cases underwent cystoscopy and 33 cases underwent cystoscopy. Posterior urethra. The results of bladder and posterior urethral calculi, abnormal structure of bladder neck, posterior urethral false passage and urethrorectal fistula were compared with those of traditional urethrography. According to the visual analogue pain scale (VAS), the pain was evaluated one day after the examination, and the difference between the two groups was compared between the soft cystoscopy and the traditional rigid microscope. Results the position of urethral stricture, posterior urethral structure, bladder and intravesical calculi could be more clearly understood by soft cystoscopy. The posterior urethral calculi, bladder neck structure and posterior urethral false passage could be found by cystoscopy. Urethrorectal fistula was found in 7 and 5 cases respectively, which was significantly different from the conventional imaging findings. The pain score of transurethral and transurethral fistula was significantly lower than that of hard endoscopy. Conclusion on the basis of traditional imaging examination in patients with posterior urethral stricture of pelvic fracture, soft cystoscopy can provide more comprehensive and effective preoperative evaluation. The patient has high pain tolerance and high clinical value for correct diagnosis and treatment of the disease. It is worth popularizing the preoperative examination method.
【作者單位】： 上海交通大學(xué)附屬第六人民醫(yī)院泌尿外科;
【分類號(hào)】：R699

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