尿道

Methods: Twenty-five cases of urethral diseases underwent urethral retrograde contrast sonography and other ways (X-radial urethral contrast, urethroscope and emiction way of urethral contrast).

用逆行尿道声学造影检查25例尿道疾病患者。同时作X线尿道造影、尿道镜、排尿法尿道声学造影进行对比。

In 9 boys suffered from dysuria, cloudy urine and recurrent fever, posterior urethral valvewith vesico-ureteral refluxwas diagnosed on micturatin cystourethrography and IVU. The reflux was found on 15 sides. Valve ablation by endoscopic fulguration was carried out for 7 and by urethrotomy fulguration in 2. Catheterization was needed for 25～28 months because of difficult urination in the latter 2. Normal urination has been observed in the other 7 right after the operation.

报告9例因排尿困难、反复泌尿系感染等症状，经排尿性膀胱尿道造影检查发现有后尿道瓣膜及继发性膀胱输尿管返流患儿，共15侧。2例经后尿道切开电灼尿道瓣膜，术后留置尿管分别治疗25和28个月，现排尿通畅；7例经尿道内窥镜电灼尿道瓣膜，术后排尿均明显改善。

Part two: Urethroplasty by using skin oversleeve with vesicomucosa to treat hypospadias.

为解决单独使用膀胱粘膜尿道成形术后并发症较多的问题，我们设计了皮肤袖套式膀胱粘膜尿道成形术治疗重型尿道下裂及部分首次手术失败的尿道下裂患儿，即用游离包皮内板或游离阴囊中隔皮片在尿道外口处做成一短段尿道，然后用游离膀胱粘膜形成全段人工尿道并从包皮内板或游离阴囊中隔皮片做成的尿道内穿出。

Objective To investigate the nursing intervention in preclusion of post-urethroplasty urinary fis-tula of hypospadia.Methods 70urethroplasty cases were randomly divided into2groups,the urethral stents were douched with0.9%N.S in the cotrol group,and the integrated nursing interventionwas applied in the treatment group,the INI includerays the use of10ml0.9%N.S plus80000units gentamicin for douche,swabbing genitals with nitrofurazone solution and infrared rays exposure of genitals.

目的 采用护理干预手段预防尿道下裂术后尿瘘的发生方法选择尿道下裂带蒂皮瓣正位开口期尿道成形术患者70例随机分 2组：一组是常规用生理盐水冲洗尿道支架管方法；另一组是生理盐水10ml加庆霉素8万U冲洗新尿道支架管，呋喃西林溶液擦拭外阴部以及红外线伤口局部照射的护理干预方法综合护理，观察尿瘘的发生率。

Methods: Selected 93 confirmed cases with hypospadias during May 2003 to Sep 2009. Patients in balanic type were treated with meatal advancement and glandularp lasty; patients with urethra orifice at 2/3 of corpus penis accompanied with slight chordee of penis were treated with Snodgrass method or Onlay method; patients with severe chordee of penis were treated with Duckett method; patients in scrotum or perineum type were treated with combination of Duplay and Duckett; severe hypospadia patients were treated with curved pedicle penis-scrotum and skin flap urethroplasty; patients with good outer plate of ventral prepuce and chordee of penis were treated with ventral pedicle hooded foreskin flap.

选取2003年5月～2008年9月期间收治的93例确诊尿道下裂患者，对阴茎头型患者采用尿道口前移、阴茎头成形法；尿道口在阴茎体外2/3段伴有阴茎轻度下弯者采用尿道板纵切卷管法或加盖岛状皮板法（Snodgrass术或On-lay术）；有严重阴茎下弯的所有阴茎体型采用横裁或纵裁包皮岛状皮瓣尿道成形；阴囊型或会阴型用阴囊中缝皮管加横裁包皮岛状皮瓣成形尿道（Duplay联合Duckett术）；对重度尿道下裂患儿采用弧形带蒂阴茎阴囊联合皮瓣尿道成形术；对腹侧包皮外板发育良好患儿及合并阴茎下曲的患儿采用腹侧带蒂帽状包皮皮瓣法。

Methods: Selected 93 confirmed cases with hypospadias during May 2003 to Sep 2009. Patients in balanic type were treated with meatal advancement and glandularp lasty; patients with urethra orifice at 2/3 of corpus penis accompanied with slight chordee of penis were treated with Snodgrass method or Onlay method; patients with severe chordee of penis were treated with Duckett method; patients in scrotum or perineum type were treated with combination of Duplay and Duckett; severe hypospadia patients were treated with curved pedicle penisscrotum and skin flap urethroplasty; patients with good outer plate of ventral prepuce and chordee of penis were treated with ventral pedicle hooded foreskin flap.

选取2003年5月～2008年9月期间收治的93例确诊尿道下裂患者，对阴茎头型患者采用尿道口前移、阴茎头成形法；尿道口在阴茎体外2/3段伴有阴茎轻度下弯者采用尿道板纵切卷管法或加盖岛状皮板法(Snodgrass术或Onlay术)；有严重阴茎下弯的所有阴茎体型采用横裁或纵裁包皮岛状皮瓣尿道成形；阴囊型或会阴型用阴囊中缝皮管加横裁包皮岛状皮瓣成形尿道(Duplay联合Duckett术)；对重度尿道下裂患儿采用弧形带蒂阴茎阴囊联合皮瓣尿道成形术；对腹侧包皮外板发育良好患儿及合并阴茎下曲的患儿采用腹侧带蒂帽状包皮皮瓣法。

The surgery of female stress urinary incontinence has more ways,but it is essentially around two main themes:First,extense urethra,narrow urethra cavity diameter,increase urethral wall tension; Second,improve the bladder neck location,restore bladder urethra horn,recover the pressure transfer to urethra side when abdominal pressure increases,thus increase the urethral atresia pressure and length of the urethra,reach the aim to control incontinence.

女性压力性尿失禁手术治疗的方法较多，但本质上主要围绕两个主题进行：一是延长尿道，缩小尿道腔径，增加尿道壁张力；二是提高膀胱颈位置，恢复膀胱尿道后角，恢复增加腹压时压力向尿道侧的传递，从而增加尿道闭锁压及机能尿道长度，以达控制尿失禁的目的。

We concluded that uroflowmetry was a simple, non-invasive procedure which provided an objective evaluation of the uroflow in hypospadias. Urethral stricture after urethroplasty could be diagnosed with uroflowmetry. The low flow rate in congenital hypospadias was mainly due to meatal stenosis. Oral mucosa graft combined with a local flap for hypospadias repair provided satisfactory functional results.

我们推论：尿流率测定评价尿道下裂患者排尿功能，方法简便，准确可靠，对尿道下裂术后尿道狭窄具有诊断意义；先天性尿道下裂患者尿流率曲线多数呈平台形，最大尿流率降低，其主要原因为尿道外口狭窄；口腔粘膜片移植与局部皮瓣耦合组建尿道修复尿道下裂功能性效果良好。

Objective: To explore the mechanisms resulting in the recurrence of urethral scar which make urethral strictures difficult to be cured, a series experiments were conducted to find potential effective factors involved in urethral scar formation and degradation, including the studies of extracellular matrix component of urethral stricture scar, the characteristics of urethral scar fibroblast, and the effects of urine on urethral fibroblast in vitro, as well as the studies to compare the difference of collagenase activity, type Ⅰ collagen and tissue inhibitor of metalloproteinase-1 (TIMP-1) in the tissues and cultured fibroblasts from normal urethra and strictured urethra respectively, and the studies to investigate the effect of antisense TIMP-1 oligodeoxyonucleotide on cell proliferation and collagenase activity of urethral scar fibroblast.

中文题名尿道瘢痕基础研究副题名胶原酶活性，TIMP-1的表达及其反义基因治疗外文题名 Experimental study on urethral scar-activity of collagenase，expression of TIMP-1，and antisense TIMP-1 gene transfection of urethral scar fibroblast 论文作者黄翔导师杨宇如教授学科专业外科学研究领域\研究方向学位级别博士学位授予单位四川大学学位授予日期2002 论文页码总数104页关键词尿道手术瘢痕胶原酶成纤维细胞尿道瘢痕馆藏号BSLW /2003 /R699 /12 目的：研究尿道瘢痕的细胞外基质的组成，尿道瘢痕成纤维细胞的生物学特性以及尿液对其生长的影响；比较胶原酶活性，金属蛋白酶组织抑制因子-1（TIMP-1）以及Ⅰ型胶原含量在尿道瘢痕和正常尿道组织及体外培养的成纤维细胞中的差异；研究反义TIMP-1寡核苷酸对尿道瘢痕成纤维细胞增殖以及胶原酶活性的影响。

Result The patients of posterior urethral stricture using the posterior urethrascope have been followed up for 1 moth to 22 years,clinical results:good in 89cases\general in 23cases\poor in 12cases\failed in 9cases,good rate being 84.2%,succeeding rate being 93.2%;The patients of preceding urthrostenosis using the preceding urethrastenosis cutting knife have been followed up for 16 years,the patients using the urethrastenosis dilator have been followed up for 7moths to 7years,the result is good.

经尿道一次性完成手术操作。结果：应用后尿道狭窄切开器治疗各种不同类型的后尿道狭窄133例，经1月至22年随访，效果优者89例，良者23例，差者12例，失败9例。优良率84.2%，有效率93.2%；前尿道狭窄切开刀治疗前尿道狭窄3例，随访16年，效果良好；系列尿道狭窄扩张器治疗尿道狭窄3例，经7个月至7年随访，效果良好。

Do you know, i need you to come back

你知道吗，我需要你回来

Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。