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目的分析妇科手术泌尿系统损伤22例的临床特点与处理。方法回顾性分析22例妇科手术泌尿系统损伤的部位、发现时间、术后尿瘘的发生、诊治和预后。结果在8799例妇科手术中,发生泌尿系统损伤22例(0.25%)。其中,输尿管下端损伤15例,膀胱损伤7例。发现泌尿系统损伤时间:术中16例(72.7%),术后住院期间4例(18.1%),出院后2例(9.2%)。发生尿瘘5例(22.7%)。均及时实施手术或给予相应的治疗。随访6~18个月,22例均恢复良好,肾功能正常。结论手术是引起泌尿系统医源性损伤的主要因素;及早发现并适当处理,预后一般较好。
Objective To analyze the clinical features and treatment of urinary system injury in gynecological surgery in 22 cases. Methods A retrospective analysis of 22 cases of gynecological surgery urinary tract injury site, found that time, postoperative urinary fistula, diagnosis and treatment and prognosis. Results In 8799 gynecological operations, urinary system injuries occurred in 22 cases (0.25%). Among them, the lower ureter injury in 15 cases, bladder injury in 7 cases. Urinary system injury was found in 16 (72.7%) patients during operation, 4 (18.1%) after hospitalization and 2 (9.2%) after discharge. Urinary fistula occurred in 5 cases (22.7%). All were promptly implemented surgery or given the appropriate treatment. All cases were followed up for 6-18 months. All the 22 cases recovered well and their renal function was normal. Conclusions Surgery is the main cause of iatrogenic iatrogenic injury. Early detection and appropriate treatment have better prognosis.