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目的:探讨输尿管端端吻合术加带蒂大网膜包裹治疗输尿管下段损伤性狭窄的有效性及安全性。方法:从1989年3月至2006年6月,使用输尿管端端吻合加用大网膜包裹治疗输尿管下段损伤性狭窄16例,对临床资料进行了回顾性分析。结果:术后早期漏尿1例,肾萎缩3例。术后4～10周拔除双J管,拔管后再狭窄2例。全部病例术后随访发现输尿管解剖在位,蠕动排空良好,肾积水肾功能得到明显改善。未见有与手术相关的严重并发症。结论:在证实损伤输尿管远段尚有残留后,输尿管端端吻合加带蒂大网膜包裹治疗输尿管下段损伤性狭窄,安全性高,并发症少,实用性强,值得在基层医院推广使用。
Objective: To investigate the effectiveness and safety of ureteral end-to-end anastomosis plus pedicled omental wrapping in the treatment of traumatic ureteral injury. Methods: From March 1989 to June 2006, ureteral end-to-end anastomosis and omental wrapping were used to treat 16 cases of traumatic ureteral stricture. The clinical data were retrospectively analyzed. Results: Early postoperative leakage of urine in 1 case, 3 cases of renal atrophy. After 4 to 10 weeks removed double J tube, extubation after restenosis in 2 cases. Follow-up of all cases found ureteral anatomy in place, good peristalsis was emptied, renal function of hydronephrosis was significantly improved. No serious complications related to surgery were found. Conclusion: There are still some residual ureteral segments in the injured area. The anastomosis of the ureter and the pedicled omental wrapping are effective in the treatment of the lower ureteral injury with high safety, less complications and strong practicability. It is worth to be popularized in primary hospitals.