摘要
本文介绍各种难治阴道尿瘘41例的修补方法。其中获得痊愈者38例,占92.7%;好转者2例,占4.9%;失败者1例,占2.4%。文中根据瘘管的部位、大小、结构及粘连等主要特点进行瘘管分类,并结合手术难度估计和选择手术方法:还介绍了各种瘘管的修补方法。
Forty-one cases of various refractory vaginourinary fistulas were admitted from 1968 to 1981, 23 of which had been operated 1-4 times in other hospitals. Thirtyeight (92.7%) of the 41 cases weer repaired with success, 2 were much improved and 1 failed. The following factors are the keys to successful repairing: (1) Scar tissue around urinary fistula openings should always be dissected to such an extent that these openings could be sutured up without undue tension. (2) A purse string suture is used during closure o the opening in order to prevent leakage of urine. (3) In cases of vesical openings or presence of much scar tissue, operation would be rendered much easier if paravesica spaces be freed on one or both sides. (4) The tension on the vaginal fistula opening may be released by Z-plasty or by suturing the cervix to theposterior fascia of pubic arch. (5) If necessary, neighbouring muscle may be used to reinforce the fistula closure
出处
《上海医学》
CAS
1983年第5期274-279,共6页
Shanghai Medical Journal
