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目的探讨螺旋状带蒂膀胱肌瓣修复输尿管中下段长段缺损的疗效。方法选取2010年6月—2012年6月菏泽市牡丹人民医院通过螺旋状带蒂膀胱肌瓣来修复输尿管中下段长段缺损的患者共50例,治疗后对其恢复的效果进行评估。结果手术时间80~185 min,住院时间为8~12d,术后2周拔除导尿管,术后6周均顺利拔除双J管。手术成功48例,均排尿顺畅,无返流及阻塞情况,超声及造影技术检查发现患者尿路积水情况明显改善。另外2例病患出现不同程度的尿瘘现象,同时由轻度输尿管膀胱返流,在半年的恢复后再次进行手术均成功治愈。结论输尿管中下段长段缺损患者应用螺旋状带蒂膀胱肌瓣修复治疗具有较好的效果,手术成功率相对较高,且能及时解决患者困扰的问题,并发症少。
Objective To investigate the curative effect of helical bandage bladder flap in repairing long segment of lower ureter. Methods From June 2010 to June 2012, Peony People’s Hospital of Heze City, through the spiral pedunculated bladder muscle flap to repair a long segment of the middle and lower ureteral defects in 50 patients, after treatment, the effect of recovery was evaluated. Results The operation time was 80 to 185 minutes and the hospitalization time was 8 to 12 days. The catheter was removed 2 weeks after operation and the double J tube was successfully removed 6 weeks after operation. The operation was successful in 48 cases, both voiding smooth, no reflux and obstruction, ultrasound and imaging techniques found that patients with urinary tract water was significantly improved. The other 2 patients showed different degrees of urinary fistula, while mild ureteral reflux, after six months of reoperation were successfully cured. Conclusions The application of helical pedunculated bladder muscle flap in the treatment of long segment of lower ureter has good effect, the success rate of operation is relatively high, and can solve the problem of patients’ distress promptly with few complications.