摘要
目的了解国内近年男性尿道狭窄的病因与治疗方式的变化状况。方法回顾性收集2004年1月至2009年12月国内8个医疗中心收治的3455例男性尿道狭窄患者的资料，分析尿道狭窄的主要病因、治疗方法及随时间变迁病因和治疗技术的变化。结果3455例患者的病因分别为：外伤1833例（53．05％），其中骨盆骨折1327例（38．41％），骑跨伤506例（14．65％）；医源性1181例（34．18％），其中经尿道手术602例（17．42％），尿道下裂术后291例（8．42％），留置导尿管164例（4．75％）；其他较少见的为尿道炎201例（5．82％），硬化性苔藓样病149例（4．31％），原因不明者91例（2．63％）等。2004—2006年，腔内技术是治疗尿道狭窄最为常见的方法，共709例（52．67％）；而2007—2009年这种技术应用减少，共726例（34．42％），两者间差异有统计学意义（P〈0．01）。2007—2009年开放性尿道成形术逐年增多（1243例，58．94％），与2004—2006年相比（563例，41．83％）差异有统计学意义（P〈0．01）。结论外伤和医源性损伤是尿道狭窄的常见原因，近年逐渐增多；尿道狭窄治疗方法主要是腔内微创手术和开放性尿道成形。2007—2009年经腔内手术比例显著下降，而开放性尿道成形手术比例显著上升。
Objective To investigate the etiology and management of male urethral stricture at 8 medical centers in China during the period from 2004 to 2009 years, and to investigate whether there were any changes in etiology and management of urethral stricture with time change. Methods The database on 3455 male patients with urethral stricture who underwent treatment at 8 medical centers in China between January 2004 and December 2009 were prospectively collected. The databases were analyzed for possible cause of stricture and treatment techniques for urethral stricture, and for the changes in etiology and management with time change. Results There were 3455 operations for urethral stricture during the study period. The main causes of urethral strictures were traumas in 1833 patients （53.05%） , among which pelvic fractures were in 1327 （38.41%） and perineal trauma in 506 （ 14.65% ）. The second cause was iatrogenic causes in 1181 patients （34. 18% ） , among which transurethral operations or examinations were in 602 （17.42%） , hypospadias surgery in 291 （8.42%） and urethral catheterization in 164 （4.75%）. Less common causes were urethritis in 201 patients （5.82%） , lichen sclerosus in 149 （4.31%） , undefined in 91 （2.63%）. The treatments of urethral strictures were endourologieal surgery including internal urethrotomy and dilation and open urethroplasty including end-to-end urethroplasty and the substitude urethroplasty etc. The ratios of using various techniques in total number of patients were obviously different by time. The most application technique for treatment of urethral stricture was endourological surgery （709） during 2004 - 2006 and occupied 52.67% in total number of patients. It was gradually decreased during 2007 - 2009 （726） and only occupied 34.42% （P 〈 0.01 ）. Open urethroplasty gradually increased during 2007 - 2009 （ 1243, 58.94% ） compared with the first three years （563, 41.83% ） （ P 〈 0.01 ）. Conclusions During the recent years there was an increase in the incidence of urethral stricture being trauma and iatrogenic causes. The main treatments of urethral strictures were endourological surgery and open urethroplasty. Endourological surgery was significantly decreased in total number of patients, while open urethroplasty were significantly increased during the late three years.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2012年第5期329-332,共4页
Chinese Journal of Urology
关键词
尿道狭窄
病因
治疗
医源性
多中心研究
Urethral stricture
Etiology
Treatment
Iatrogenic disease
Multicenter study
