医源性输尿管损伤的原因与处理

目的：探讨医源性输尿管损伤的原因、处理和预防。方法：本组16例，保守治疗行输尿管逆行插管（以J管）2例，输尿管修补术1例，输尿管端端吻合术3例，输尿管膀胱吻合术7例，肾造口术3例，其中2例后期再次行管状膀胱瓣输尿管吻合术。结果：所有患者肾功能均恢复正常。结论：了解与输尿管有关的解剖位置，细致规范的手术操作是预防医源性输尿管损伤的关键。

The cause management and of iatrogenic ureteral injuries (Report of 16 cases)

Purpose:To discuss the cause,treatment and precaution of iatrogenic ureteral injuries.Methods:16 cases of iatrogenic ureteral injuries were reported.The injuries occurred with abdominal surgery were 4 cases,with gynecological operation and obstetric procedures and operations were 12,Types of injury include ligation, crush, laceration, avulsion, stretch and devascularization. 4 cases were found during operation time and the diagnosis of the rest 8 cases were established readily on the history,IVU,retrograde pyeloureterography and dye studies.Results:Ureteroureterostomy or ureteroneocystostomy were carried out for 10 patients, ureterostomy for 3 patient, conservative cure(double J tube) for 2 patients. All patients were cured.Conclusion:It was suggested that careful and exact operation as well as acquaintance with the anatomy of ureter before and during surgery be key to precaution of iatrogenic ureteral injuries.