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妇科手术后发现的输尿管损伤的早期治疗。

Early treatment of ureteral injuries found after gynecological surgery.

作者信息

Béland G

出版信息

J Urol. 1977 Jul;118(1 Pt 1):25-7. doi: 10.1016/s0022-5347(17)57874-x.

Abstract

Five consecutive patients with 7 ureteral injuries found after gynecological operations were treated conservatively. The complications ensuing this type of management are reported briefly. Twenty more consecutive patients with 27 ureteral injuries were treated immediately after diagnosis and definitively. Important points of technique are 1) little attempt to stay extraperitoneally, 2) sacrifice of all abnormal ureter, 3) re-establishment of ureteral continuity between a normal ureter and the bladder by usual means, 4) peritoneal closure only when easy, 5) adequate drainage and 6) use of antibiotics. The results obtained were excellent. Early and definitive treatment of ureteral injuries found after gynecological operations seems to be the safest and easiest type of management in all cases.

摘要

对五例在妇科手术后发现有7处输尿管损伤的连续患者进行了保守治疗。简要报告了这种治疗方式所引发的并发症。另外连续20例有27处输尿管损伤的患者在确诊后立即接受了确定性治疗。重要的技术要点包括:1)尽量少尝试在腹膜外操作;2)切除所有异常输尿管;3)通过常规方法重建正常输尿管与膀胱之间的输尿管连续性;4)仅在操作容易时缝合腹膜;5)充分引流;6)使用抗生素。所取得的结果非常好。对于妇科手术后发现的输尿管损伤,早期进行确定性治疗在所有情况下似乎都是最安全、最简便的治疗方式。

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