摘要
目的总结探讨双J支架管用于盆腔复杂手术中输尿管损伤的预防和诊治经验。方法本组61例均为妇产科、普通外科盆腔复杂手术患者,麻醉后放置双J输尿管支架管,其中双侧29例,单侧32例。结果术中直视下辨认输尿管23例(37.7%),根据双J管触诊辨认输尿管54例(88.5%)。输尿管部分缝扎及完全结扎各1例;输尿管部分破损伴漏尿1例,分别给予松解缝扎、结扎线和输尿管修补,恢复良好。本组术后未出现血肌酐升高病例。术后发现输尿管下端坏死1例,输尿管下端狭窄伴肾积水1例,此2例均行输尿管膀胱吻合术治疗。其它患者均恢复良好。结论双J支架管用于盆腔复杂手术中可明显提高输尿管的辨别率,减少输尿管的误伤,有助于输尿管缝扎、结扎及破损病例的早期诊断和治疗,对迟发性输尿管损伤病例有保护肾功能的作用。
Objective To explore the prevention, diagnosis and management of ureteral injury in complicated pelvic surgery with double-J stent. Methods Double-J stents was used in 61 patients in complicated pelvic surgery from 1997 to 2004. Results Ureter was identified in 23 cases （ 37.7% ） under direct visualization, and in 54 cases （ 88.5% ） with the help of palpation of the stents in the ureters, with a higher rate of identification in the latter. Two cases of ureteral injury were diagnosed during the operation with the help of the stents and were treated timely with excellent recovery. Two cases of ureteral injury were diagnosed late after the operation with no signs of hydronephrosis before further surgical management. Conclusion The use of double-J stents may improve the identification of ureter in complicated pelvic surgery, and improve the early diagnosis and management of ureteral injury, which helps reducing the incidence of ureteral injury, and protects renal function in some cases of delayed ureteral injury.
出处
《创伤外科杂志》
2006年第1期16-18,共3页
Journal of Traumatic Surgery
