膀胱阴道瘘42例的诊断与治疗  

Diagnosis and treatment of vesicovaginal fistula,a report of 42 cases

作　　者：石奇刚[1] 孙永恒[1] 肖昱[1] 李栓玲[1] 杜斌[1] 刘瑞强[1] 

机构地区：[1]濮阳市人民医院泌尿外科,河南濮阳457000

出　　处：《临床和实验医学杂志》2009年第7期94-95,共2页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨妇科手术后并发膀胱阴道瘘的诊断、手术时机和手术途径。方法42例妇科手术后并发膀胱阴道瘘的患者,均经膀胱镜检查和膀胱内注亚甲蓝试验或多层螺旋CT尿路成像(MSCTU)确诊。除1例经留置导尿管后自愈,3例恶性肿瘤复发未作修补外,其余38例均于损伤发生后3～6个月行修补术,其中27例经膀胱手术径路,6例经腹腔和膀胱联合手术径路,5例经阴道手术径路。结果38例手术均获成功,无并发症,术后随访6～12个月,无复发。结论为提高膀胱阴道瘘的修复效果,应根据患者的一般情况、瘘管的性质、手术者的经验,来选择对膀胱阴道瘘手术时机和手术途径。Objecive To assess the diagnosis, the best time and the way for operation of vesicovaginal fistula caused by gynecologic surgery. Methods Forty two eases with vesieovaginal fistula developed after gynecological operation were exactly diagnosed by inspections of eystoseopy, experimental injection of methylene blue into urinary bladder or multi - slice spiral CT urography （MSCTU）. Among 42 cases, VVF was self - healed by indwelling urethral catheter in I ease ; it bad not been repaired in 3 cases due to the recurrence of malignancy and it was mended in remaining 38 cases in three to six months after the occurrence of injury . Surgical approach for urinary bladder was undertaken in 27 cases, united surgical approach through abdominal cavity and urinary bladder was undergone in 6 cases and surgical approach through vagina was carried out in 5 cases. Results All cases were cured by operation and no other complications recurred within follow - up period for 6 to 12 months. Conclusion In order to enhance the effect of restoration, the best time and way for surgical treatment of vesicovaginal fistula should be based on situation of patients, characteristics of fistula and surgical experience of surgeons,

关 键 词：膀胱阴道瘘 诊断 治疗 

分 类 号：R71[医药卫生—妇产科学] R699[医药卫生—临床医学]