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外暴力所致输尿管损伤相当少见。发病率占所有腹部损伤的3—17％。作者1979—1984年治疗输尿管损伤49例,47例为穿透伤;2例为钝性伤。男45例;女4例。术前做IVP42例,37例获得确诊(88.1％),12例术中证实。其中肾盂或肾盂输尿管交界处(PVJ)损伤22例(45％);中段伤11例(22.4％);盆段损伤12例(24.5％);膀胱壁段损伤4例(8.1％)。手术大多采用一期输尿管端端吻合术,另有5例输尿管膀胱吻合术伴腰大肌悬吊,3例输尿管膀胱吻合术与1例肾盂成形术。术后并发症8例:输尿管狭窄3例;输尿管皮肤瘘2例;尿性囊肿2例与肾局脓肿1例。其中5例需二次手术。
Ureteral injury caused by external violence is quite rare. The incidence accounts for 3-17% of all abdominal injuries. The authors treated 49 cases of ureteral injury in 1979-1984, 47 cases of penetrating wounds and 2 cases of blunt trauma. 45 males and 4 females. Preoperative IVP 42 cases, 37 cases were confirmed (88.1%), 12 cases confirmed by surgery. Among them, 22 cases (45%) had renal pelvis or ureteropelvic junction (PVJ) injury, 11 cases (22.4%) had pelvic injury, 12 (24.5%) pelvic injuries and 4 (8.1%) bladder wall injuries. One-stage ureteral end-to-end anastomosis was used in most of the surgeries. In addition, 5 cases of ureteric anastomosis with psoas suspension, 3 ureterovesical anastomosis and 1 case of pyeloplasty were performed. Postoperative complications in 8 cases: 3 cases of ureteral stricture; ureter skin fistula in 2 cases; 2 cases of urinary cysts and renal abscess in 1 case. Five of them require secondary surgery.