医源性输尿管损伤13例诊断治疗分析  

The diagnosis and treatment of iatrogenic ureteral injuries:Report of 13 cases

作　　者：刘兆伟[1] 

机构地区：[1]江苏太仓市第一人民医院泌尿外科,215400

出　　处：《中国基层医药》2002年第11期993-994,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的　探讨医源性输尿管损伤的病因、类型、诊断、治疗和预防。方法　本组 13例输尿管损伤 ,12例为输尿管下端损伤。妇产科手术损伤 9例 ,外科 4例。行输尿管修补术 2例 ,输尿管端端吻合术 5例 ,输尿管膀胱吻合术 4例 ,肾造口术 2例 ,其中 1例Ⅱ期作管状膀胱瓣输尿管吻合术 ,1例行Ⅱ期替代修补术。结果　所有输尿管损伤被治愈 ,肾功能恢复正常。结论　医源性输尿管损伤多发生在下腹、盆腔、后腹膜手术。治疗应尽早恢复排尿的通畅及保护肾功能。预防的关键在手术者应熟悉输尿管的解剖位置 。Objective To discuss the causes,types,diagnosis,treatment and prevantion of iatrogenic ureteral injuries.Methods Thirteen cases of iatrogenic ureteral injuries were reported,which included 12 cases occurred in the lower third.The injuries occurred with abdominal surgery were 4 cases,with gynecotokology operations were 9 cases.Results Prompt surgical repairs were carried out for 2 patients,ureteroureterostomy or ureterocystostomy for 9 patients and percutaneous nephrostomy for 2 patients.All patients wre cured.Conclusion Iatrogenic ureteral injuries usually occur during major abdominal or pelvic operations and retroperitoneal surgical procedures.The principles of treatment are the early diversion of urine and the preservation of renal function.It is suggested that careful and exact operation as well as an intimate knowledge of the anatomy of the ureter before and during surgery be keys to prevantion of iatrogenic ureteral injuries.

关 键 词：医源性输尿管损伤 诊断 治疗 病因 临床分类 

分 类 号：R693[医药卫生—泌尿科学]