泌尿系统损伤10年162例回顾性分析  

Retrospective analysis of 162 patients with urological trauma within a decade

作　　者：唐晨野[1] 傅强[2] 

机构地区：[1]浙江省嘉兴市第二医院泌尿外科 [2]上海交通大学附属第六人民医院泌尿外科,200233

出　　处：《中华泌尿外科杂志》2014年第8期606-610,共5页Chinese Journal of Urology

摘　　要：目的 总结泌尿系统损伤的诊治经验.方法 回顾性分析2002年3月至2012年3月收治的162例肾、输尿管、膀胱、尿道损伤患者的诊治方法及治疗结果.结果 162例经治疗均恢复顺利出院.62例肾损伤患者行保守治疗45例、超选择性肾动脉造影栓塞术9例、肾切除术8例,随访3～ 24个月肾功能均正常.2例输尿管损伤患者行膀胱镜下输尿管置管和输尿管膀胱再植术各1例,术后随访1年,B超检查均未提示患侧肾积水.6例膀胱损伤患者均采用膀胱修补术,术后随访6～12个月排尿均无异常.92例尿道损伤患者行单纯导尿6例、尿道会师术18例、膀胱镜下尿道会师术35例、尿道修补术4例、尿道端端吻合术29例,拔管后随访6 ～ 24个月,29例（32％）发生尿道狭窄,后期行进一步处理.结论 泌尿系统损伤临床多见,早期诊断和治疗十分重要,多数患者经积极治疗可获得满意的疗效,部分患者出现后期并发症,需进一步治疗.Objective To summarize the diagnosis and treatment of urological trauma.Methods One hundred and sixty-two patients with trauma of kidney,ureter,bladder or urethra were treated between March 2002 and March 2012.The diagnosis,treatment and outcome were analyzed.Results All patients were discharged with improved condition.Of 62 patients with renal injury,45 were treated with conservative approach,9 were treated with superselective arterial embolization,and 8 were treated with nephrectomy.All the 62 patients had normal renal function during the follow-up period of 3 to 24 months.Of 2 patients with ureteral injury,one was treated with cystoscopic ureteral catheterization,and another one with ureteric reimplantation.Neither of the 2 patients developed hydronephrosis during the one year follow-up period.All 6 patients with vesical injury were treated with open surgery,and they all had normal urinary function during the follow-up period of 6 to 12 months.Of 92 patients with urethral injury,6 were treated with urethral catheterization,18 with urethral realignment,35 with cystoscopic urethral realignment,4 with urethral repairment,and 29 with end-to-end anastomotic urethroplasty; 29 （32％） patients suffered from urethral stricture during the follow-up period of 6 to 24 months,and they underwent further treatment.Conclusions Urological trauma is quite frequent,and early diagnosis and treatment is important.Good outcomes will be achieved in most of patients by suitable treatments,but complications which need further treatments may occur subsequently in part of the patients.

关 键 词：泌尿系统损伤 肾 输尿管 膀胱 尿道 

分 类 号：R691.6[医药卫生—泌尿科学]