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尿道损伤不常见,但治疗最难,且有争议,没有统一的治疗方案。一个常用方案是先试插尿管,失败后立即行耻骨上探查、尿道会师术。另一常用方案是仅行耻骨上转流术。争议的焦点是尿道插管与耻骨上转流的优劣,早期开放性手术与延期尿道成形术的利弊。作者介绍一种治疗尿道损伤的新技术,即损伤后先行耻骨上转流,2周后经耻骨上及尿道进行内窥镜检查及器械操作.并带入尿管,恢复尿道连续性。具体方法如下。损伤后先试插软尿管.失败后则行耻骨上转流。可触及的膀胱则行穿刺造瘘,最大可放入F16尿管;不可触及的膀胱则需开放性耻骨上膀胱造
Urethral injury is uncommon, but the most difficult to treat, and controversial, there is no uniform treatment. A common protocol is to try the first catheterization, the failure of the pubic symphysis to explore the urethra will be masters. Another common option is only suprapubic bypass. The focus of controversy is the pros and cons of urethral intubation and suprapubic bypass, the advantages and disadvantages of early open surgery and delayed urethroplasty. The authors describe a new technique for the treatment of urethral injury, which is preceded by suprapubic bypass after injury and endoscopic and instrumented suprapubic and urethral procedures two weeks later, with catheterization and urethral continuity restoration. Specific methods are as follows. After the injury first try to insert the urethra. Failure after the suprapubic bypass. The palpable bladder is puncture fistula, the maximum can be placed F16 catheter; not accessible bladder need to open the suprapubic bladder