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目的探讨不同手术方法影响男性外伤性尿道狭窄治疗效果的相关因素。方法回顾性分析多中心的237例外伤性尿道狭窄的初次治疗效果,采用多因素分析,用卡方、卡方分割分析的统计方法分析临床疗效。结果在狭窄复发的因素中,狭窄长度分组(0～2cm,2～4cm)的P<0.05,围手术期尿路感染的P<0.05,狭窄初次治疗方式(尿扩,尿道内切开,尿道吻合)的P<0.05;狭窄的初次治疗方式,尿扩与尿道吻合比较P<0.01,尿道内切开与尿扩比较的P>0.05,尿道内切开与尿道吻合比较P<0.01。结论外伤导致的尿道狭窄长度、围手术期尿路感染、狭窄初次治疗方式是影响尿道狭窄复发的重要因素;尿道狭窄的长度与尿道内切开的疗效相关,狭窄长度<2cm复发率低,>2cm复发率高;尿道吻合术的影响因素与狭窄长度、狭窄部位、既往手术史无关,与围手术期尿路感染及手术本身有关,与其他手术方式相比,尿道吻合治疗外伤性尿道狭窄复发率最低。
Objective To investigate the related factors that affect the treatment effect of traumatic urethral stricture in different surgical methods. Methods A retrospective analysis of multi-center 237 cases of traumatic urethral stricture of the initial treatment effect, using multivariate analysis, using chi-square, chi-square analysis of statistical methods to analyze the clinical efficacy. Results Among the factors of the recurrence of stenosis, there were no significant difference between the two groups (P <0.05 for stenosis length group (0-2 cm, 2-4 cm), P <0.05 for perioperative urinary tract infection, initial treatment for stenosis (P <0.05). The initial treatment of stenosis, urinary expansion and urethral anastomosis compared with P <0.01, urethral incision and urinary expansion compared P> 0.05, urethral incision and urethral anastomosis compared P <0.01. Conclusion The length of urethral stricture, perioperative urinary tract infection and initial treatment of stenosis are the important factors affecting the recurrence of urethral stricture. The length of urethral stricture is related to the curative effect of urethral incision, the recurrence rate of stenosis <2cm is low, 2cm recurrence rate; urethral anastomosis factors and stenosis length, stenosis, previous history of surgery has nothing to do with the perioperative urinary tract infection and the operation itself, compared with other surgical methods, urethral anastomosis treatment of traumatic urethral stricture recurrence The lowest rate.