CAJ | 학술논문

目的探讨术前预置输尿管导管在盆腔粘连患者行腹腔镜全子宫切除术中防治输尿管损伤的有效性和安全性.方法 2008年1月至2011年5月69例术前预置输尿管导管在盆腔粘连患者行腹腔镜全子宫切除术为研究组.同期有73例患者为术前未预置输尿管导管行腹腔镜全子宫切除术患者为对照组,观察两组患者的临床疗效和输尿管损伤的发生率.结果研究组和对照组平均手术时间分别为(112±25) min和(113±25) min;术中出血量分别为(50±28) ml和(48±25)ml;术后平均住院日分别为(5±4)d和(5±5)d；手术后血红蛋白改变量分别为(-5±9)g/L和(-5±9)g/L.两组比较差异无统计学意义(P＞0.05),输尿管损伤并发症:研究组有1例术中发现输尿管损伤,术后给予留置输尿管导管3d后拔除,未发生输尿管阴道瘘,对照组有8例术后发生输尿管阴道瘘,差异有统计学意义(P＜0.05).结论对有盆腔手术史的患者行腹腔镜全子宫切除术,术前预置输尿管导管是一种安全、有效的预防术中损伤输尿管的方法.
목적 탐토술전예치수뇨관도관재분강점련환자행복강경전자궁절제술중방치수뇨관손상적유효성화안전성.방법 2008년1월지2011년5월69례술전예치수뇨관도관재분강점련환자행복강경전자궁절제술위연구조.동기유73례환자위술전미예치수뇨관도관행복강경전자궁절제술환자위대조조,관찰량조환자적림상료효화수뇨관손상적발생솔.결과 연구조화대조조평균수술시간분별위(112±25) min화(113±25) min;술중출혈량분별위(50±28) ml화(48±25)ml;술후평균주원일분별위(5±4)d화(5±5)d；수술후혈홍단백개변량분별위(-5±9)g/L화(-5±9)g/L.량조비교차이무통계학의의(P＞0.05),수뇨관손상병발증:연구조유1례술중발현수뇨관손상,술후급여류치수뇨관도관3d후발제,미발생수뇨관음도루,대조조유8례술후발생수뇨관음도루,차이유통계학의의(P＜0.05).결론 대유분강수술사적환자행복강경전자궁절제술,술전예치수뇨관도관시일충안전、유효적예방술중손상수뇨관적방법.
Objective To investigate the efficacy and safety of presetting ureteral catheter before total laparoscopic hysterectomy for preventing ureteral injury in patients with pelvic adhesions.Methods One hundred and forty-two cases of total laparoscopic hysterectomy were enrolled in this research from January 2008 to May 2011.They were divided into two groups,69 cases of pelvic adhesions in the study group were preset with ureteral catheter before total laparoscopic hysterectomy.In the control group,73 cases were not set with ureteral catheter before surgery.The clinical efficacy and occurrence rate of ureteral injury of the two groups were observed.Results The average operation time was ( 112 ±25) min and ( 113 ±25) min in the study group and control group,respectively.The average blood loss was ( 50 ± 28 ) ml and (48 ± 25 ) ml,respectively.The average length of hospital stay after surgery was (5 ±4) d and (5 ±5) d,respectively.The hemoglobin change was ( 5 ±9) g/L and ( 5 ±9) g/L;respectively.There was no significant difference between the two groups ( P ＞ 0.05 ).There was 1 case of ureteral injury in the study group,who was indwelled with ureteral catheter for 3 days before removal.There was no ureteral fistula occurred in the study group.In control group,there were 8 eases of ureteral fistula after operation.There was significant difference between the two groups ( P ＜0.01 ).Conclusions It is a safe and effective prevention method of presetting ureteral catheter before total laparoscopic hysterectomy for ureteral injuries in patients with pelvic adhesions.