妇产科手术泌尿道损伤临床分析  

Investigation of the Urinary Tract Injury in Obstetrics and Gynecology Operation Control Measures

作　　者：路士芬 

机构地区：[1]临沂市第三人民医院,山东临沂276023

出　　处：《中国伤残医学》2015年第11期20-21,共2页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的：探讨妇产科手术泌尿道损伤的防治措施，为预防与诊疗提供借鉴。方法：采用回顾性的分析方法，以2002年2月-2012年12月某院收治并行妇产科手术患者共13927例作为研究对象，统计发生泌尿道损伤患者例数、处理措施以及结局。结果：13927例行妇产科手术患者发生泌尿道损伤38例，发生率为0．27％，输尿管损伤29例，损伤构成比76．32％、发生率0．21％，9例为膀胱损伤，构成比23．68％，发生率0．06％；闭合手术8376例发生损伤18例构成比47．36％、发生率0．2l％；开放手术5551例发生损伤20例、构成比52．63％、发生率0．36％，差异具有统计学意义（P〈0．05）；术中行修补术34例，成功占89．47％，其中28例输尿管损伤，6例膀胱损伤，行2次手术修复4例，占10．53％，1例输尿管损伤，3例膀胱损伤；术后并发1例泌尿道感染。结论：妇产科行开腹手术中病情较重、腹腔环境复杂，患者易造成泌尿道损伤，医师应提高警惕、操作确切，防止误伤，术中发现损伤第一时间行修补术，术后发现损伤需行2次手术修补，手术时机据患者损伤情况与病情而定。Objective： Objective： To investigate the urinary tract injury in obstetrics and gynecology operation control measures, pro- vide reference for the prevention and diagnosis. Methods： Retrospective analysis from 2002 February to 2012 December, in a hospital ob- stetrics and gynecology operation in parallel with a total of 13927 cases as the object of study, patients with urinary tract injury statistics, management and outcome. Results： 38 cases of urinary tract injury incidence was 0.27% in 13927 cases of Obstetrics and gynecology op- eration patients, 29 patients with ureteral injury was 76.32%, and injury incidence was 0.21%, consisting of 9 eases of bladder injury, which occurred in 0.06% than 23.68%, closed operation; 8376 cases of injury in 18 cases constitutes more than 47.36%, the incidence of 0.21% ; 5551 open operation eases of injury in 20 cases, the constituent ratio of 52.63%, the incidence was 0.36%, the difference was statistically significant （P 〈 0.05） ; the intraoperative repair was performed in 34 cases successfully accounted for 89.47%, inclu- ding 28 cases of ureteral injury, 6 cases of bladder injury, the 2 operation to repair 4 cases accounted for 10.53 %, 1 cases of ureteral in- jury, 3 cases of bladder injury; 1 cases with urinary tract infection after operation. Conclusion： open abdominal operation in Department of gynecology and obstetrics illness heavier, peritoneal environment complex is easy to cause urinary tract injury patients, physicians should be alert, exact operation, prevent accidental injury, damage was found first time for repair of intraoperative, postoperative found injury and required repair two times operation, operation time according to injury and disease patients set.

关 键 词：妇产科手术 泌尿道损伤 损伤处理 

分 类 号：R473.71[医药卫生—护理学]