脱细胞异体真皮在尿瘘修补中的临床疗效分析

Clinical analysis of human acellular allogeneic dermis in the repair of urinary fistula

目的探讨脱细胞异体真皮(HADM)在尿瘘修补中的临床疗效。方法回顾性分析厦门大学附属第一医院2021年6月—2022年11月收治的12例女性复杂性膀胱阴道瘘采用HADM修补患者的临床资料。患者年龄38~56岁,平均47.3岁;体质量指数(BMI)16.6~25.2,平均21.3。12例患者术中经阴道途径均采用HADM填补修补瘘口。术中将HADM置入阴道、膀胱壁瘘口之间。结果12例手术均顺利完成。术后阴道漏尿停止,保留尿管2周,术后随访1~16个月,未见复发。所有病例均未发生手术并发症。结论在复杂性膀胱阴道瘘手术治疗中,经阴道采用HDMA修补瘘口,对患者创伤小、恢复时间短、成功率高,是比较理想的修补复杂膀胱阴道瘘的方法。

Objective To investigate the clinical efficacy of human acellular allogeneic dermis(HADM)in the repair of urinary fistula.Methods The clinical data of 12 female patients with complex vesicovaginal fistula treated during Jun.2021 and Nov.2022 were retrospectively analyzed.The patients average age was 47.3 years,ranging from 38 to 56 years.The body mass index(BMI)ranged from 16.6 to 25.2,with an average of 21.3.HADM was inserted between vagina and bladder wall fistula to repair fistula in all 12 patients.Results All operations were successful.After the operation,the vaginal urine leakage stopped and the urinary tube was retained for 2 weeks.During the postoperative follow-up of 1 to 16 months,no recurrence or complication were observed.Conclusion Transvaginal HDMA is an ideal surgical method in the treatment of complex vesicovaginal fistula,which has advantages of small trauma,fast recovery and high success rate.