武汉地区妇科手术中泌尿道损伤的流行病学调查分析  

Epidemiological investigation of urinary tract injury in gynecologic surgery in Wuhan

作　　者：林松[1] 耿红琼[1] 程时刚[1] 张伶俐[2] 

机构地区：[1]湖北省妇幼保健院泌尿外科,武汉430070 [2]湖北省妇幼保健院妇科,武汉430070

出　　处：《中国性科学》2017年第12期48-51,共4页Chinese Journal of Human Sexuality

摘　　要：目的:调查武汉地区妇科手术中泌尿道损伤的发生情况,并分析相关因素,为加强泌尿道损伤的管理提供参考。方法:回顾性分析2015年6月至2016年6月在武汉地区7362例行妇科手术的患者,对其进行回顾性研究分析。结果:7362例行妇科手术患者中,共有24例患者发生泌尿道损伤,发生率为0.32%,其中输尿管损伤16例(0.22%),膀胱损伤8例(0.11%)。在手术方法中,以腹腔手术导致术中泌尿道损伤的发生率最高,为0.45%。在疾病类型中,子宫内膜癌及内膜异位症术中致泌尿道损伤的发生率最高,均为0.07%;在妇科手术方式中,广泛性子宫全切术引起的泌尿道损伤发生率最高,为2.46%。在导致妇科手术中泌尿道损伤的原因中,因癌性致密粘连造成患者泌尿道损伤的发生率最高(33.33%),而失误操作也是导致妇科手术中泌尿道损伤的主要原因之一,为25.00%。结论:武汉地区妇科手术中泌尿道损伤以输尿管损伤为主,腹腔镜手术术中泌尿道损伤并发症发生率最高,子宫颈癌、内膜异位症等广泛性子宫全切术致泌尿道损伤高发,致密粘连、失误操作是造成泌尿道损伤的主要因素,而子宫骶骨韧带处及子宫动脉横跨输尿管处为泌尿道损伤的高发部位。Objectives： To investigate the incidence of urinary tract injury in gynecologic surgery in Wuhan,and to analyze the related factors,so as to provide reference for the management of urinary tract injury.Methods： A retrospective analysis was conducted on 7362 patients undergoing gynecological surgery in Wuhan from June 2015 to June 2016. Results： Among 7362 cases of gynecological surgery,a total of 24 cases of urinary tract injury occurred,an incidence rate of 0. 32%. There were 16 cases of ureteral injury（ 0. 22%）,8 cases of bladder injury（ 0. 11%）. During the operation,the incidence of urinary tract injury was the highest,which was 0. 45%. In the type of disease,endometrial carcinoma and endometriosis had the highest rate causing urinary tract injury（ 0. 07%）. In the way of gynecological surgery,urinary tract injury caused by extensive uterine cutting technique had the highest rate（ 2. 46%）. In the cause of urinary tract injury in gynecologic surgery,urinary tract injury caused by carcinodense adhesion had the highest rate（ 33. 33%）,and the operation mistake was one of the main causes of urinary tract injury in gynecologic surgery（ 25%）. Conclusion： In Wuhan,urinary tract injury in gynecological surgery includes ureter injury and urinary tract injury,which has the highest incidence rate. Cervical cancer,endometriosis and other extensive hysterectomy caused by urinary tract injury have high incidence rate. Adhesion and operational mistakes are the main factors causing urinary tract injury,and sacral ligament the uterus and uterine artery across the ureter urinary tract are the position with high incidence rate.

关 键 词：武汉地区 妇科手术 泌尿道损伤 流行病学调查 

分 类 号：R691.6[医药卫生—泌尿科学]