闭合性输尿管破裂6例的诊治体会  

An Experience on 6 Cases Closed Ureteral Rupture

作　　者：邓争鸣[1] 高成绩 李庆文[2] 王志峰 

机构地区：[1]安徽省五河县人民医院,安徽五河233300 [2]蚌埠医学院附属医院泌尿外科,安徽蚌埠233000 [3]安徽省五河县第二人民医院,安徽五河233300

出　　处：《河北医学》2006年第12期1262-1264,共3页Hebei Medicine

摘　　要：目的：探讨闭合性输尿管破裂的临床特征。方法：回顾分析6例闭合性输尿管破裂的临床资料。结果：2例在早期剖腹探查中明确诊断，1例于伤后d2明确诊断，另3例在伤后5—25d才明确诊断。3例早期行一期输尿管或输尿管肾盂端端吻合术，2例于损伤3个月后行尿液性囊肿切除输尿管端端吻合术，1例行单纯尿液引流。随访4个月至5年。均行静脉肾盂造影、B超、血Cr、BUN检查；2例肾轻度积水，1例吻合口轻度狭窄，余3例均正常。结论：尿外渗、肾积水是输尿管破裂的主要表现，大剂量静脉肾盂造影及逆行插管输尿管造影、CT检查对本病的诊断有重要价值。急诊手术探查，争取一期修复有利于提高疗效。Objective：To study the clinical characteristics of closed ureteral ruputure. Method：Review and analysis the clinical datas 6 cases closed ureteral ruputure. Result：2 cases were made definite diagnosis among celiotomy exploratory, 1 case was diagnosed next day after injury, Another 3 cases werent made deft- nite diagnosis until 5 - 25 days later. 3 cases were taken ureter or ureter to renal pelvis end - to - end one - stage anastomosis early ,2 cases were taken urinary cyst resection and ureter end -to- end anastomosis three months later, 1 case performed extravsation of urine drainage only. The follow - up period ranged from 4 months to 5 years ,All of them were taken intravenous urography （IVU） ,B -ultrosenography,blood Cr ,BUN examination ;2 cases were found slight hydronephrosis, 1 case was found slight anastomotic stenosis, The other 3 cases are normal. Conclusion： Urinary extravsation,hydronephrosis are the main characteristics of ureteral rupture,The IVU of great dose and retrograde pyelograpgy,CT have important value on ureteral rupture diagnosis. The emergency operation exploratory , One - stage repair must improve the curative effect .

关 键 词：输尿管破裂 影像学诊断 外科手术 

分 类 号：R693[医药卫生—泌尿科学]