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目的 探讨医源性输尿管损伤的病因、类型、诊断、治疗和预防。方法 本组 13例输尿管损伤 ,12例为输尿管下端损伤。妇产科手术损伤 9例 ,外科 4例。行输尿管修补术 2例 ,输尿管端端吻合术 5例 ,输尿管膀胱吻合术 4例 ,肾造口术 2例 ,其中 1例Ⅱ期作管状膀胱瓣输尿管吻合术 ,1例行Ⅱ期替代修补术。结果 所有输尿管损伤被治愈 ,肾功能恢复正常。结论 医源性输尿管损伤多发生在下腹、盆腔、后腹膜手术。治疗应尽早恢复排尿的通畅及保护肾功能。预防的关键在手术者应熟悉输尿管的解剖位置 ,作好充分的术前准备和细致规范的手术操作
Objective To investigate the etiology, types, diagnosis, treatment and prevention of iatrogenic ureteral injury. Methods 13 cases of ureteral injury in this group, 12 cases of lower ureteral injury. Obstetrics and gynecology surgery injury in 9 cases, surgery in 4 cases. 2 cases of ureter repair, 5 cases of ureteric anastomosis, 4 cases of ureteric anastomosis, 2 cases of renal ostomy, 1 case of tubular anastomosis for bladder flap, and 1 case of alternative repair . Results All ureteral injuries were cured and renal function returned to normal. Conclusion iatrogenic ureteral injury occurred in the lower abdomen, pelvic and retroperitoneal surgery. Treatment should be as early as possible to restore urination and protection of renal function. The key to prevention Operators should be familiar with ureteral anatomical location, make adequate preoperative preparation and detailed normative surgical procedures