妇科腹腔镜手术中泌尿系损伤的临床特点及处理

The clinical features and treatment of urinary tract injury in gynecological laparoscopic operation

目的:探讨妇科腹腔镜手术发生泌尿系损伤的主要原因、诊断、治疗方法及预防措施。方法:回顾分析2004年5月至2010年12月妇科腹腔镜手术发生泌尿系损伤患者的临床资料,总结分析患者疾病类型、盆腔情况、手术方式、损伤特点、诊疗情况及预后等。泌尿系损伤均经泌尿科手术治疗。结果:2 138例妇科腹腔镜手术中,共发生输尿管损伤7例,膀胱损伤2例,总泌尿系损伤率0.42%。经泌尿科手术,预后良好。结论:泌尿系损伤是妇科腹腔镜手术较严重的并发症,术者需高度警惕,术后注意观察,一旦出现术后腹痛、腹胀、恶心呕吐、发热、阴道流液、腹膜炎等症状时,应及时进行相关检查,及时处理,治疗以手术为主。

Objective：To study the main reason, diagnosis, treatment and prevention of urinary tract injury in gynecological lap- aroscopic operation. Methods：The clinical data of 9 patients who suffered urinary tract injury in gynecological laparoscopic operation from May 2004 to Dec. 2010 was retrospectively analyzed. The type of disease, condition of pelvic cavity, way of operation, character of injury, diagnosis, treatment and prognosis were summarized. All the patients were treated by urological surgery. Results：There were 7 urinary tract injuries and 2 bladder injuries among 2 138 gynecological laparoscopic operations, the rate of urinary tract injury was 0.42%. All of these symptoms had a better prognosis after proper treatment. Conclusions ： Urinary tract injury is a serious complication in gynecological laparoscopie operation and the symptoms of abdomen pain, abdomen distension, nausea and vomiting, fever, vaginal fluid, peritonitis and so on must be paid attention after operation. Once complications mentioned above happened, proper examining and treatment must be taken. The surgery is the main treatment method.