45例妇产科手术损伤泌尿器官的临床分析

Clinical analysis of urinary tract injury in gynecologic surgery in 45 cases

目的探讨妇产科手术过程中损伤泌尿器官的易发因素及其防治方法。方法对45例妇产科手术损伤泌尿器官患者的临床资料进行回顾性分析。结果 45例中输尿管损伤33例,均为下段输尿管损伤,其中近膀胱处损伤24例,骨盆入口处损伤9例;左侧输尿管损伤16例,右侧输尿管损伤10例,双侧输尿管损伤7例,输尿管横断伤9例,结扎伤11例,输尿管穿孔7例,粘连6例,17例手术中诊断,16例于术后24~72 h诊断,经及时正确修补、松解等治疗均治愈。膀胱损伤12例,其中顶部损伤6例,底部损伤6例,均于手术中诊断经膀胱修补I期修复治愈。结论妇产科手术中损伤泌尿器官为严重并发症,重要在于预防,如果损伤发生,及时发现并积极治疗,患者通常预后良好。

Objective To explore the inducing factors and control measures of urinary organ injury during gynecologic surgery.Methods The clinical data of 45 cases of urinary organ injury in gynecologic surgery were retrospectively analyzed.Results Of the 45 cases,33 cases were of urethral tract injury（lower urethral tract injury） including 24 cases of injury near the bladder,9 cases of pelvic injury at the entrance;16 cases of left urethral injury,10 cases of right urethral injury,7 cases of bilateral urethral injury,9 cases of urethral transaction,11 cases of ligation injury,7 cases of urethral perforation,6 cases of adhesion.Among the 33 cases of urethral tract injury,17 cases were found during the operation and 16 cases were diagnosed within 24 to 72 hours after the operation.All patients with urethral tract injury recovered through the timely repair and correct treatment.Bladder injuries were found in 12 cases（6 in the top and 6 at the bottom）.All cases were found and diagnosed during the operation and got recovered after the stage-I surgical repair.Conclusion Urinary organ injury in gynecologic surgery is a serious complication;therefore great importance should be attached to it.Timely detection and aggressive treatment are needed if the injury occurred