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目的:探讨曲安奈德联合透明质酸酶行尿道瘢痕内注射治疗早期外伤性尿道瘢痕狭窄的疗效。方法:将20例外伤性尿道瘢痕狭窄的病人分为两组,在尿道外伤手术、拔除尿管1周后10例作为治疗组:应用曲安奈德联合透明质酸酶尿道瘢痕内注射治疗;10例作为对照组:应用曲安奈德尿道瘢痕内注射治疗;观察患者治疗前及治疗6个月后的自主排尿、最大尿流率、尿道瘢痕体积的变化,比较两组的疗效。结果:两组均随访6个月,治疗6个月后尿道瘢痕明显缩小、软化,排尿通畅。对照组最大尿流率为(15.63±0.76)mL/s;治疗组最大尿流率为(17.40±0.81)mL/s;治疗组最大尿流率明显高于对照组(P<0.05),瘢痕体积、两组疗效比较无明显差异(P>0.05)。结论:外伤性尿道瘢痕狭窄患者在尿道外伤手术、拔除尿管1周后早期行尿道瘢痕内曲安奈德联合透明质酸酶注射治疗,可以明显缩小、软化尿道瘢痕,对于尿道瘢痕性狭窄的治疗有较好的疗效,且较单纯应用曲安奈德治疗有一定的优势。
Objective: To investigate the curative effect of triamcinolone acetonide combined with hyaluronidase in urethral scar injection for the treatment of early traumatic urethral scar stenosis. Methods: Twenty patients with traumatic urethral scar were divided into two groups. Ten patients underwent urethral trauma surgery and one week after removal of the catheter. The patients were treated with triamcinolone acetonide plus hyaluronidase in urethral scar injection. Cases as a control group: the application of triamcinolone acetonide injection of urethral scar; observation of patients before and 6 months after treatment of spontaneous urination, maximum flow rate, urethral scar volume changes, the efficacy of the two groups were compared. Results: Both groups were followed up for 6 months. After 6 months of treatment, the scar of urethra was obviously reduced, softened and voided. The maximum urinary flow rate in the control group was (15.63 ± 0.76) mL / s, and the maximum urinary flow rate in the treatment group was (17.40 ± 0.81) mL / s. The maximum urinary flow rate in the treatment group was significantly higher than that in the control group (P <0.05) Volume, there was no significant difference between the two groups (P> 0.05). Conclusion: Traumatic urethral scar stenosis in urethral trauma surgery, early removal of the urinary catheter 1 week after triamcinolone acetonide combined with hyaluronidase injection can significantly reduce, soften the urethra scar for the treatment of urethral cicatricial stenosis Have a better effect, and more simple application of triamcinolone acetonide treatment has certain advantages.