医源性输尿管损伤临床分析

Clinical analysis of iatrogenic ureteral injuries

摘要:

目的探讨医源性输尿管损伤的原因、类型、处理和预防.方法回顾性分析1994年5月～2003年11月13例14侧医源性榆尿管损伤临床资料.结果 1例输尿管内支架管引流、2例输尿管端端吻合内支架管引流、2例松解部分结扎及内支架管引流、7例8侧输尿管膀胱再植术,输尿管均通畅,肾功能均恢复正常,6例尿瘘治愈;1例肾切除.结论规范化操作及输尿管逆行插管对预防医源性输尿管损伤和早期发现输尿管损伤有决定性的作用和帮助;早期与后期诊断有所不同;治疗的目的是恢复输尿管通畅和保护肾功能;后期诊断病例应考虑一次性恢复输尿管通畅,尽可能不作尿流改道.

Abstract:

Objective: To discuss the cause, type, diagnosis, treatment and precaution of iatrogenic ureteral injuries (IUI). Methods: 13 cases with IUI were reviewed from 1994 to 2003. Results: Double J endrainage for one patient, ureteroureterostomy for 2 patients, ligationectomy and Double J endrainage for 2 patients, ureteroneocystostomy for 7 patients. Except 1 treated with nephrectomy, all the others were cured. Conclusion: Standardized operation and antidromic intubatton are the key to prevention and early find of IUI. Early diagnosis is different of late; Objective of treatment are repair ureteral and renal function ;When ureteral injurys are detected, they should be treatment as early as possible according to practical conditions, the nephrostomy was not necessary.