分段包埋法治愈输尿管全层全段撕脱伤（附1例报告并文献复习）  

Segmental Embedding for Curing Full-thickness Complete Ureteral Avulsion （a report of 1 case and literature review）

作　　者：唐顺利[1] 钟明[1] 李凯[1] 

机构地区：[1]广东医学院附属中山市陈星海医院泌尿外科,广东中山528415

出　　处：《医学临床研究》2012年第7期1299-1301,共3页Journal of Clinical Research

摘　　要：【目的】总结输尿管撕脱伤的处理方法，为临床工作提供借鉴和指导。【方法】报告1例53岁女性肾盂输尿管连接部梗阻（UPJO）患者行输尿管镜检查时发生输尿管全层全段撕脱，经采用输尿管肾盂原位吻合、输尿管分段包埋及输尿管膀胱吻合术而治愈，结合文献进行分析讨论。【结果】术中、术后无并发症发生，术后3个月B超复查无肾积水；术后半年B超复查示左肾轻度积水，1年后B超示左肾中度积水，IVP示UPJO并左肾中度积水，遂再次手术行左肾盂输尿管连接部（UPJ）狭窄段切除及肾盂成形术，术后恢复良好。随访1年，B超示肾血运、大小正常，无积水。【结论】该术式是治疗输尿管全层全段撕脱伤较理想的手术方法，也对长段输尿管撕脱伤具有借鉴意义，手术相对简单、安全，并发症少。[Objective] To summarize the treatment of ureteral avulsion in order to provide the reference and guidance for clinical practice. [Methods] Full-thickness complete ureteral avulsion occurred in a 53-year- old female patient with oracle ureteral junction obstruction（UPJO） undergoing ureteroscopy. The patient was cured by ureteropelvic anastomosis in situ, ureteral segment embedding and ureter-bladder anastomosis. The literature was combined for analysis and discussion. [Results] No complication occurred during and after oper- ation. No hydronephrosis was found by B-ultrasound reexamination 3 months after operation. B-ultrasound re- examination a half year after operation showed slight dropsy of left kidney. B-ultrasound a year after operation showed moderate dropsy of left kidney. IVP showed UPJO and moderate dropsy of left kidney. Reoperation including the resection of the stenosis of left kidney and nephropyelopolasty was performed. The patient recov- ered well after operation. During a year of follow-up, B-ultrasound showed that blood supply and size of the kidney were normal and no hydronephrosis was found. [Conclusion] The operation is the ideal method for the treatment of full-thickness complete ureteral avulsion, and the reference for long-segment uretheral avulsion. The surgical procedure is relatively simple and safe with few complications.

关 键 词：输聚案/损伤 

分 类 号：R693.5[医药卫生—泌尿科学]