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目的探讨膀胱阴道瘘的病因及治疗方式。方法回顾性分析1964-2005第三军医大学大坪医院34例膀胱阴道瘘患者的临床表现、治疗措施及效果。结果本资料显示1990年前膀胱阴道瘘患者病因主要为产科因素,占83·3%,而1990年后妇科手术则成为主要病因,占70·0%。手术治疗30例,一次修补成功23例,其中经阴道修补9例,腹膜内经膀胱修补5例,腹膜外经膀胱修补9例,二次修补成功7例,1例均经阴道进行,6例先后经膀胱或阴道修补成功。结论目前妇科手术为膀胱阴道瘘的主要病因,且瘘口相对简单,其治疗措施仍以手术为主;提高产科质量及妇科操作技能是预防本病的关键。
Objective To investigate the etiology and treatment of vesicovaginal fistula. Methods The clinical manifestations, treatment measures and effects of 34 cases of vesicovaginal fistula in Daping Hospital of the Third Military Medical University from 1964 to 2005 were retrospectively analyzed. Results The data showed that the causes of vesicovaginal fistula before 1990 were mainly obstetric factors, accounting for 83.3%. However, gynecological surgery was the major cause after 1990, accounting for 70.0%. Surgical treatment of 30 cases, a successful repair of 23 cases, including 9 cases of vaginal repair, intraperitoneal bladder repair in 5 cases, extraperitoneal bladder repair in 9 cases, secondary repair success in 7 cases, 1 case was vaginal, 6 cases The bladder or vaginal repair success. Conclusions Gynecological operation is the main cause of vesico-vaginal fistula, and the fistula is relatively simple. The treatment is still dominated by surgery. To improve obstetric quality and gynecological operation skills is the key to prevent this disease.