输尿管导管预防妇科腹腔镜手术中输尿管损伤的随机对照研究

Randomized controlled study of ureteral catheter on the prevention of ureteral injury during the gynecologic laparoscopic surgery running title:Prevention of ureteral injury

目的:探讨预置输尿管导管在预防妇科腹腔镜手术中输尿管损伤的价值。方法:60例需要实施腹腔镜手术的连续性住院患者,随机被分为试验组和对照组。统计分析两组在手术时间、术中估计出血量、术后下床活动时间、术后胃肠功能恢复时间、术后住院日、术后止痛剂用量、输尿管损伤发生率等方面的差异。结果:60例手术均成功完成。试验组无输尿管损伤,对照组输尿管损伤1例(3.6%),差异有统计学意义(P<0.05)。两组手术时间、术中估计出血量比较差异有统计学意义(P<0.05);两组术后止痛剂用量、术后下床活动时间、术后胃肠功能恢复时间、术后住院日等方面比较差异无统计学意义(P>0.05)。结论:术前预置输尿管导管可减少妇科腹腔镜术中输尿管损伤,减少术中出血量、节省手术时间,可作为妇科腹腔镜手术,尤其是有盆腔黏连手术的常规术前准备项目。

Objective：To explore the value of ureteral catheter preventing the ureteral injury during the gynecologic laparoscopic surgery. Methods：The data of 60 cases which need undergo the laparoscopic surgery were randomly divided into test group and control group. The operative course,amount of bleeding during the operation,postoperative out- of- bed activity time,postoperative recovery time of gastrointestinal function,hospital stays,postoperative analgesic dose and the incidence rate of ureteral injury were compared between two groups. Results：All the 60 cases were successfully performed the surgery. Patients from the test group had not ureteral injury,but 1 cases suffered from ureteral injury in the control group（ 3. 6%）,with statistically significant difference（ P 0. 05）. Furthermore,the operation time and amount of bleeding during the operation were significant differences between two groups（ P 0. 05）,and there were no statistically significant differences of postoperative analgesic dose,out- of- bed activity time,recovery time of gastrointestinal function and hospital stays between two groups（ P 0. 05）. Conclusion：Preplacing ureteral catheter before the surgery can reduce the ureteral injury during the gynecologic laparoscopic surgery,and decrease the amount of bleeding and save the operation time. Moreover,it became the routinely preoperative preparation item in the gynecologic laparoscopic surgery,especially for the operations with pelvic adhesion.