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女性尿道损伤常由分娩时胎头或产钳损伤所致,由外伤直接引起者颇为少见。我院自1982年以来共收治3例,现报告如下。例1 18岁。劳动中不慎骑跨式跌倒,会阴部被树桩戳伤,会阴流血,不能排尿,于1982年11月6日急诊入院。体检:T36.9℃,P 102次/分,BP14/9.3kPa.下腹部膨隆,膀胱充盈于脐耻之间,右侧大小阴唇及阴道前壁大片裂伤,尿道口难以分辨,挤压膀胱及用力排尿无尿液流出,尿道显示不清。入院诊断:①会阴部撕裂伤,②尿道前段断裂,急诊手术,经下腹正中切口切开膀胱,自膀胱颈口向尿道内插入探子约2 cm达会阴创口,修整近端尿道,置入F18导尿管。游离切取3.5×2 cm左侧小阴唇带蒂壁瓣,围绕导尿管缝成2 cm长粘膜皮管与尿道近端对端吻合,修复延长尿道远端,放置引流缝合阴部裂口。术后14天拔出导尿管,排尿通畅,无尿失禁,创口一期愈合出院。随访5年,排尿正常。
Female urethral injury often caused by childbirth fetal head or forceps injury, caused directly by the trauma is quite rare. Our hospital since 1982 treated a total of 3 cases, are as follows. Example 1 18 years old. Labor accidentally saddle-stalking fall, perineal stump injury, perineal bleeding, can not urinate, on November 6, 1982 emergency admission. Physical examination: T36.9 ℃, P102 beats / min, BP14 / 9.3kPa. The lower abdomen bulge, bladder filling between the umbilical shame, the size of the labia minora and vaginal anterior large laceration, urethra difficult to distinguish, squeeze the bladder And forced urination without urine outflow, urethra unclear. Admission diagnosis: ① perineal laceration, ② anterior urethral rupture, emergency surgery, incision through the lower abdomen incision bladder, from the bladder neck to the urethra into the urethra about 2 cm up to the perineum wounds, repair the proximal urethra, into the F18 Catheter. Free left 3.5 × 2 cm small labial pedicle pedicle flap, around the catheter into 2 cm long mucosal skin tube and proximal urethral anastomosis, repair and extend the distal urethra, drainage drain suture placed genitals. 14 days after the removal of the catheter, voiding patency, incontinence, wound healing a discharge. Follow-up for 5 years, normal urination.