严重多发伤输尿管损伤的救治

Treatment of ureteral injury with severe multiple trauma

目的 总结严重多发伤中输尿管损伤的救治经验。方法 回顾分析我院1990年9月～2 0 0 4年6月收治的14例严重多发伤中输尿管损伤病例的临床资料。结果 9例早期诊断,均行输尿管吻合术,均Ⅰ期愈合;2例延迟诊断,1例行肾切除,另1例经Ⅱ期手术修复。插管成功3例,其中2例治愈,另1例半年后复查,因肾积水加重而行输尿管修复治愈。结论 对严重多发伤中输尿管损伤的救治应全面检查,防止漏诊,及时合理手术是治疗的关键。

Objective To summarize the therapeutic experience of ureteral injury with severe multiple traumas.Methods The clinical data of 14 cases with ureteral injury with severe multiple traumas treated in our hospital from Sep.1990 to Feb.2004 were analyzed retrospectively.Results Nine cases received early diagnosis,all of them were treated by ureteroureterostomy.The diagnosis was delayed in 2 cases,in which nephrectomy was performed in 1 case,and another case was treated with secondary prosthesis.Successful intubation was found in 3 cases,of whom 2 cases were cured,another case developed hydronephrosis after 6 months and was also cured by ureteral prosthesis.Conclusion Careful examination,preventing missed diagnosis and timely operation are the key to successful treatment.