妇科手术中的泌尿系统损伤

目的 :分析了发生于我科手术中的泌尿系统损伤 17例 ,以防治妇科手术中的泌尿系统损伤。方法 :总结1989～ 1998年 10年间妇科手术中 17例患者泌尿系统损伤发生的原因、部位、诊断、处理及预后。结果 :10年间在妇科手术中发生泌尿系统损伤的患者 (17例 )占同期术者 0 31% ,其中 9例为膀胱损伤 ,8例为输尿管损伤。损伤多发生在由于炎症、肿瘤浸润、盆腔子宫内膜异位症、陈旧性宫外孕等病变造成盆腔粘连 ,巨大肿瘤压迫以及术中解剖关系不清时。其中 15例于术中诊断、术中手术修补 ,除 1例外均愈合好 ,另 2例于术后 2d及 7d诊断 ,经二次手术修补。结论 :术中应正确操作 ,如发生损伤 ,应术中诊断、及时处理。

The injury of urinary system in gynecologic operation

Objective: To study and analyze 17 cases of urinary injury in gynecologic operation for prevention and treatment. Methods: The cause, position, diagnosis, treatment and prognosis of injury in these patients from 1989 1998 were studied. Results: There were 17 cases(0.31%) of urinary injury for the past 10 years, of which 9 were bladder injury, and 8 were ureteral injury. The injury usually happened at the pelvic pathologic adhesion caused by inflammation, tumor invasion, pelvic endometriosis, old ectopic pregnancy, giant tumor impression, and abnormal anatomy. 15 cases were found during the operation; they were recognized and repaired by surgery, and healed well except one. The 2 cases were recognized on 2 and 7 days after operation, and a second operation was made. Conclusion: Gynecologic operations should be performed correctly, and the urinary injury should be recognized and repaired in the operation of injury. (J Beijing Med Univ, 2000,32:172 274)