内镜会师治疗输尿管断裂  

Endoscopic Realignment for The Treatment of Ureteral Rupture

作　　者：黄伟[1] 宋飞[1] 赵谦[1] 侯飓[1] 郭环宇[1] 韩增篪[1] 邵建国[1] 

机构地区：[1]山东中医药大学第二附属医院泌尿外科,山东济南250001

出　　处：《求医问药（下半月刊）》2011年第11期511-511,共1页Seek Medical and Ask The Medicine

摘　　要：目的探讨内镜会师治疗输尿管断裂的的方法和疗效。方法自2005年6月～2010年2月共收治输尿管瘘患者6例。4例发生于子宫切除手术后,2例发生于直肠癌术后。尿瘘发生时间为术后2～24d,平均13d。术后行IVP、逆行肾盂造影等检查确诊输尿管完全横断,断端分离。术中行B超引导穿刺肾造瘘,顺行放置斑马导丝,输尿管镜于输尿管远侧断端出去向近侧断端寻找到斑马导丝后拉出,顺行放置双J管,留置肾造瘘管。结果留置双J管2～3个月,经肾造瘘造影复查无输尿管狭窄,可拔除双J管及肾造瘘管,随访1～2年。1例术后出现狭窄行输尿管镜下内切开后治愈。结论对于手术等造成输尿管断裂,内镜下会师,放置肾造瘘、双J管治疗具有微创、高效等优点。Objective To Discuss endoscopic realignment for the treatment of ureteral rupture methods and curative effect.Methods From 2005 June to 2010 February were treated 6 patients with ureteral fistula.Occurred in 4 cases of hysterectomy operation,occurred in 2 cases of postoperative rectal cancer.The fistula occurred as a postoperative 2 ～ 24D,the mean 13d.Postoperative IVP,retrograde pyelography to diagnose ureteral completely transected,broken end separation.the B ultrasound guided puncture nephrostomy,antegrade placement of zebra guidewire,ureteroscopy for ureteral distal end to the proximal stump out find zebra guidewire after pulling out,antegrade placement of indwelling double J tube,renal fistula.Results ：The results of indwelling double J tube for 2 ～ 3 months,the renal fistula angiography review can be removed without ureteral stricture,double J tube and renal fistula,followed up for 1 ～ 2 years.1 cases of postoperative stricture underwent ureteroscopic incision after cure.Conclusion The operation caused by ureteral rupture,endoscopic realignment,placing the nephrostomy,double J tube with a minimally invasive treatment,high efficiency.

关 键 词：瘘 输尿管 阴道 腔内治疗 双J管 

分 类 号：R713.3[医药卫生—妇产科学]