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目的:探讨手术损伤输尿管的好发部位、原因、预防及早期诊断和治疗。方法:对手术可能损伤输尿管者,术前插输尿管导管以利术中识别输尿管。术中创面渗液明显多者,要注意有无输尿管损伤并用靛胭脂或美兰检查。术中及时发现的输尿管损伤根据损伤部位的不同分别采用输尿管端端吻合术或输尿管膀胱再植术治疗。手术24h后发现的输尿管损伤先行肾造瘘术,3月后行输尿管端端吻合或输尿管膀胱再植术。结果:本组1例行输尿管端端吻合术,7例行输尿管膀胱再植术,全部治愈. 结论:医源性输尿管损伤只要诊治措施得当是可以预防避免发生的。
Objective: To investigate the incidence of ureteral trauma, its causes, prevention and early diagnosis and treatment. Methods: Surgery may damage the ureter, preoperative catheterization of ureteral surgery to identify the ureter. Intraoperative wound exudate was significantly more, pay attention to the presence of ureteral injury and check with indigo rouge or Meilan. Intraoperative ureteral injury found in time according to the different parts of the lesion were treated with ureteral anastomosis or ureter bladder replantation. Ureteral injury was found after surgery for 24 hours. First, ureter endoscopic anastomosis or ureteric bladder replantation was performed in March. Results: In this group, ureteral end-to-end anastomosis was performed in 1 case and ureteric bladder was replanted in 7 cases, all of them were cured.Conclusion: Iatrogenic ureteral injury can be prevented and avoided only if the diagnosis and treatment measures are properly taken.