输尿管插管预防妇科疑难腹腔镜手术中输尿管损伤

目的:探讨输尿管插管在妇科疑难腹腔镜手术中的应用价值。方法:选取2011年1月—2013年10月181例行妇科疑难腹腔镜手术的患者(研究组),术前均通过膀胱镜放置双侧输尿管导管,术中在输尿管导管指示下行腹腔镜手术,术后立即拔除导管;同时选取同期在同院行妇科腹腔镜手术的201例患者作为对照组,术前未行输尿管插管。结果:研究组双侧输尿管置管成功率98.90%(179/181),无输尿管损伤患者。对照组中有2例发生输尿管损伤,2例发生膀胱损伤。研究组手术时间(190±12)min,对照组手术时间(242±25)min,两者比较差异有统计学意义(P0.05);研究组术中出血量(30±24)mL,对照组术中出血量(390±29)mL,差异有统计学意义(P0.05)。结论:术前放置输尿管导管可降低妇科疑难腹腔镜手术中损伤输尿管的可能性且可以缩短手术时间,减少术中出血量。

Application of Ureteral Catheter in Complicated Laparoscopic Gynecologic Surgery

Objective：This study aims to investigate the application value of ureteral catheter in complicated laparoscopic gyne- cologic surgery. Methods：A total of 181 patients undergoing complicated laparoscopic gynecologic surgery were enrolled in this study. Bilateral ureteral catheters were inserted using cystoscopy. Then laparoscopic surgery was conducted. The catheter was immediately removed after surgery. Another 201 patients undergoing laparoscopic gynecologic surgery were selected as control group. Results： The success rate of bilateral urethral catheterization was 98.90% （179/181 ）. No urethral injuries were found in the study group. In the control group, 2 cases of ureteral injury and 2 cases of bladder injury were found. The operation time in the study group was （190 ± 12） minutes, and that in the control group was （242 ± 25） minutes （P〈0. 05）. Bleeding amount in the study group was （30 ± 24） mL, and that in the control group was （390 ± 29） mL （P〈0.05）. Conclusions： The application of ureteral catheter in complicated Iaparoscopic gynecologic surgery can reduce the rate of urethral injuries during the opera tion, the operative time and intraoperative blood loss.