医源性输尿管损伤的防治(附23例报告)

Treatment of iatrogenic ureteral injuries(a report of 23 cases)

目的 探讨医源性输尿管损伤的原因、治疗和预防措施。方法 本组 2 3例 ,其中行输尿管逆行放置双J管内引流 6例 ,输尿管端端吻合术 1 4例 ,输尿管膀胱吻合术 1例 ,肾造瘘术 2例 ;6个月后期行管状膀胱瓣输尿管吻合术。结果 切肾率为 0 ,所有患者肾功能均恢复正常。结论 输尿管损伤的治疗以及时恢复其连续性和完整性 ,并放置内支架 (双J管 )引流具有十分重要的意义 。

Objective To explore the cause,treatment and prevention of iatrogenic ureteral injuries.Methods In 23 cases of iatrogenic ureteral injuries,retrograde inserted tube double J tube to ureteral was performed in 6 patients,end to end ureteral anastomosis in 15 cases,uretrocystostomy in 1 case,and pelviosicoplasty in 2 cases.Results The rate of nephrectomy was 0,and all the patients were cured.Conclusion It is very important to treat ureteral injuries in time and to use double J tube for drainage.The key to the prevention of iatrogenic ureteral injuries is preoperative implantation of ureteral catheter(double J tube) and careful operation procedure.