论文部分内容阅读
目的探讨外伤性尿道损伤的急救控制措施和早期处理方案。方法回顾性分析三门峡第三人民医院处理的外伤性尿道损伤28例,进行补液、输血、纠正血流动力学不稳定,治疗效果不理想者,行双侧髂内动脉主干及主要分支双重结扎控制大出血,在病情及条件允许的情况下,行尿道端端吻合术及膀胱造瘘术或尿道会师牵引固定术。结果所有病例均在早期得到控制,2例出现感染,对症治疗后好转,随访1~3 a,治愈17例,并发尿道狭窄8例,尿失禁3例。结论双侧髂内动脉主干及主要分支双重结扎术是控制外伤性尿道损伤大出血的有效措施。尿道会师牵引固定术缩小了尿道断端错位距离,减小二期手术难度,且操作简单,安全有效,临床可优先选择。
Objective To investigate the emergency control measures and early treatment of traumatic urethral injury. Methods 28 cases of traumatic urethral injury treated by Sanmenxia Third People’s Hospital were retrospectively analyzed. After rehydration, blood transfusion and correction of unstable hemodynamics, the treatment effect was not satisfactory. The bilateral internal iliac artery trunk and main branch double ligation control Hemorrhage, the condition and conditions permitting, urethral end anastomosis and bladder ostomy or urethra traction division fixation. Results All the cases were controlled in the early stage. In 2 cases, the infection was improved. After the symptomatic treatment was improved, the patients were followed up for 1 to 3 years, 17 cases were cured, 8 cases were complicated with urethral stricture and 3 cases were incontinence. Conclusion Bilateral ligation of the main internal iliac artery and the main branch double ligation is an effective measure to control the haemorrhage of traumatic urethral injury. Urethra traction division fixation will reduce the distance of dislocation of the urethra, reducing the difficulty of the second phase of operation, and the operation is simple, safe and effective, clinical priority.