论文部分内容阅读
目的 探讨医源性输尿管损伤的诊治及预防。方法 １３ 例医源性输尿管损伤，其中直肠癌根治术损伤２ 例，妇科手术损伤５ 例，输尿管镜取石损伤１ 例，体外震波碎石（ Ｅ Ｓ Ｗ Ｌ） 损伤２ 例，其它手术损伤４ 例。４ 例为术中即发现损伤，２ 例手术探查明确诊断，其余７ 例依据病史、 Ｉ Ｖ Ｕ、逆行造影及染料染色检查于术前明确诊断。结果 １０ 例行输尿管吻合或输尿管膀胱吻合术，１ 例行输尿管皮肤造口术，１ 例 Ｅ Ｓ Ｗ Ｌ 损伤保守治疗，１ 例行血透治疗。１３ 例均获痊愈。结论 术前及术中了解与熟知输尿管的解剖位置，细致、规范的手术操作是预防医源性输尿管损伤的关键。
Objective To investigate the diagnosis and treatment of iatrogenic ureteral injury. Methods Thirteen cases of iatrogenic ureteral injury, including 2 cases of radical resection of rectal cancer, 5 cases of gynecological surgery, 1 case of ureteroscopic stone injury, 2 cases of extracorporeal shock wave lithotripsy (ESWL) and 4 cases of other surgical injuries . 4 cases were found to be intraoperative injury, 2 cases of surgical exploration to confirm the diagnosis, the remaining 7 cases based on history, I V U, retrograde angiography and dye staining in the preoperative diagnosis. Results Ten cases underwent ureterostomy or ureterostomy, one underwent ureteral skin ostomy, one conservative treatment with EWL injury and one with hemodialysis. All 13 cases were cured. Conclusions Understanding and familiarizing the ureter anatomical location preoperatively and intraoperatively, meticulous and standardized surgical operation is the key to preventing iatrogenic ureteral injury.