摘要
目的:探究与分析腹腔镜与输尿管镜治疗妇科手术致输尿管损伤的临床效果。方法:选取我院自2012年9月至2015年9月收治的100例妇科手术致输尿管损伤患者,按照不同处理方式分为腹腔镜组与输尿管镜组,每组各50例,腹腔镜组给予腹腔镜下输尿管修补术联合内支架引流术,输尿管镜组给予输尿管镜下输尿管支架引流术,对比两组患者手术时间、术中失血量、尿瘘平均消失时间、双J管留置时、治疗前后肾功能及并发症发生率。结果:腹腔镜组与输尿管镜组相比尿瘘平均消失时间、双J管留置时间均无明显差异(P>0.05)。相比手术时间、术中失血量有显著差异(P<0.05),两组患者的随访时间无明显差异(P>0.05),且均未出现感染、肾功能异常、肾积水、输尿管狭窄、输尿管梗阻等严重并发症,在随访期间未见1例复发。腹腔镜与输尿管镜组治疗后较治疗前相比Scr降低、BUN降低、肾小球滤过率升高(均P<0.05)。两组治疗后相比SCr、BUN及肾小球滤过率无明显差异(P>0.05)。结论:采用腹腔镜下输尿管修补术联合内支架引流术与输尿管镜下输尿管支架引流术治疗妇科手术致输尿管损伤均具有显著疗效,易于被患者认可接受,值得推广。
Objectives： To explore the clinical effect of ureteroscopy and laparoscopic in treating ureteral injury caused in gynecological surgery. Methods： 108 patients with ureteral injury caused in gynecological surgery in our hospital from September 2012 to September 2015 were divided into laparoscopic group and ureteroscopy group,each of 54 cases. The laparoscopic group was given laparoscopic ureteral repair joint stent drainage,while ureteroscopy group was given ureteroscopic ureteral stent drainage. The operation time,intraoperative blood loss,and average disappearing time of urinary fistula,double J tube indwelling,renal function before and after treatment and complication rates in the two groups were compared. Results： Difference in the average disappearing time of urinary fistula and double J tube indwelling time between the two groups was not significant（ P〉 0. 05）,but that in operation time and intraoperative blood loss was significant（ P〈 0. 05）. The follow- up time was without obvious difference（ P〉0. 05）,with no infection occurred,including kidney dysfunction,kidney seeper,ureteral stricture,ureteral obstruction,recurrence and other serious complications. The Scr and BUN decreased while glomerular filtration rate increased after treatment in both groups（ all P〈 0. 05）,without significant difference between the two groups（ P〉 0. 05）. Conclusion： Both laparoscopic ureteral repair joint stent drainage and ureteroscopic ureteral stent drainage is effective in treating ureteral injury caused in gynecological surgery,which is convenient and worth promoting.
出处
《中国性科学》
2016年第10期60-63,共4页
Chinese Journal of Human Sexuality
基金
河北省沧州市2015年科学技术研究与发展指导计划项目(151302041)
关键词
腹腔镜
输尿管修补术
内支架引流术
输尿管镜
双J管
Laparoscope
Repair of ureterovaginal fistula
Stent drainage
Ureteroscope
Double J tube
