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在骨盆骨折的外伤中,合并后尿道损伤的发病率各家报道不一,由4.1—25%,这与骨盆骨折的严重程度和类型有关。国内朱通伯等在一组较重的骨盆骨折病例中,统计尿道损伤的发病率为15.6%。后尿道损伤的主要并发症有尿道狭窄、阳萎和尿失禁。目前对这种外伤的处理方法仍有争论,一派主张伤后立即手术以恢复尿道的连续性,尽可能使将来产生的尿道狭窄较短或者完全避免狭窄;另一派认为对局部的操作会加重损伤而使部分断裂的尿道完全断裂,增加阳萎的发病率。他们主张,作为急症处理,单纯行膀胱造瘘,形成的尿道狭窄以后可用尿道成形术治疗。有人主张对部分性尿道断裂行单纯膀胱造瘘;对完全性断裂,则行急症手术以恢复尿道的连续性。
In the traumatic pelvic fractures, the incidence of post-combination urethral injury varies from 4.1-25%, which is related to the severity and type of pelvic fracture. Domestic Zhu Tong Bo, etc. In a group of severe pelvic fracture cases, the incidence of urethral injury was 15.6%. The main complications of posterior urethral injury are urethral stricture, impotence and urinary incontinence. Currently there is still controversy about how to deal with this type of trauma. One group advocates surgery immediately after injury to restore the continuity of the urethra, shorten the urethral stricture to be generated in the future as far as possible or avoid stenosis in the future. Another group believes that local operations may aggravate the injury Leaving part of the fracture of the urethra completely broken, increasing the incidence of impotence. They contend that urethroplasty may be used to treat urethral stricture, which is a simple procedure for emergency management of bladder urethral stricture. Some people advocate simple cystostomy of partial urethral rupture; for complete rupture, then emergency surgery to restore the continuity of the urethra.