妇科手术导致膀胱阴道瘘的诊治研究进展  

Research progress of diagnosis and treatment of vesicovaginal fistula caused by gynecologic surgery

作　　者：兰竹[1] 于秀章[1] 侯敏敏[1] 郄明蓉[1] 

机构地区：[1]四川大学华西第二医院妇产科,成都610041

出　　处：《中华妇幼临床医学杂志（电子版）》2016年第4期475-478,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：四川省科技支撑计划项目(2012SZ0021)~~

摘　　要：膀胱阴道瘘(VVF)是指膀胱损伤部位与其毗邻的阴道之间形成的异常通道,为妇科手术的严重并发症之一,尤其易发生于全子宫切除术后。大部分VVF是由于妇科手术中施术者操作失误,损伤膀胱所致。根据患者漏尿症状,并结合亚甲蓝试验、膀胱镜辅助检查等,一般可对VVF进行明确诊断。VVF治疗以手术修复为主,达到使尿液恢复正常引流的目的。VVF修补术时机和手术方式,应根据患者身体状况、瘘管特点及施术者经验进行个体化选择。目前,VVF修补术在发展中国家以经阴道修补为主,而在发达国家则修补术术式较多。笔者拟就妇科手术导致的VVF诊治研究进展进行综述,旨在为临床工作者提供参考。Vesicovaginal fistula（VVF）which refers to the abnormal passage between bladder and vagina,is the most distressing complication of gynecologic surgery,and VVF mostly occurs in complete hysterectomy.Most VVF is caused by inadvertent injury to the bladder during surgery by operators.According to the symptoms of leakage of urine,combined with methylene blue test and cystoscopy,VVF can usually be exactly diagnosed.Surgical repair which aims at correcting urine efflux is the main treatment method for VVF.The timing and approach of surgical operation for VVF should be based on physical status of patients,clinical features of fistula of VVF and experience of surgeons.At present,the vaginal approach of VVF repair is the preferred one in developing countries,while in the developed countries,a variety of approaches of VVF repair have been described.This review will summarize the research progress of diagnosis and treatment for VVF resulting from gynecologic surgery,in order to provide reference for clinicians.

关 键 词：尿瘘 膀胱阴道瘘 妇科外科手术 手术中并发症 诊断 治疗 

分 类 号：R713[医药卫生—妇产科学]