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目的观察尿道损伤后上皮的修复过程,为提高手术效果寻求理论依据。方法采用8只成年雄犬,于阴茎中段切取3cm长一段尿道,然后尿道内留置支架管,并行膀胱造口术转流尿液。术后不同时段行尿道造影、光镜及扫描电镜检查,观察尿道上皮的修复情况。结果2周时尿道黏膜大部缺损,造影剂外渗明显;4、6周时创面已基本被上皮覆盖,但上皮厚薄不一且缺乏极性,造影剂仍有少量外渗;8周时创面被较厚的复层上皮覆盖,上皮形态均匀一致,与正常上皮无明显差别,无造影剂外渗。结论尿道上皮的修复是一个逐渐的过程,尿道上皮修复完全与否与尿外渗的有无关系密切,尿道手术后应根据有无尿外渗来确定拔除尿管的时间。
Objective To observe the repair process of epithelium after urethral injury, and to seek a theoretical basis for improving the surgical effect. Methods Eight adult male dogs were cut in the middle of the penis for a length of 3cm. The urethral catheter was placed in the urethra, and urine was diverted by a cystostomy. Urethral angiography, light microscopy and scanning electron microscopy were performed at different time points to observe the repair of urethral epithelium. RESULTS: Most of the mucosa of the urethra was defect at 2 weeks, and extravasation of contrast agent was obvious. At 4 and 6 weeks, the wound surface was basically covered by epithelium, but the epithelial thickness was different and lack of polarity. Contrast agent still had a small amount of extravasation. At 8 weeks, It was covered by a thick stratum mucosal epithelium and the morphology of the epithelium was uniform. There was no significant difference with normal epithelium without extravasation of contrast agent. Conclusion Urethral epithelial repair is a gradual process. Whether urethral epithelial repair is complete or not is closely related to the presence or absence of extravasation of urine. Urethral surgery should be based on the presence or absence of extravasation to determine the time of catheter removal.