CAJ | 학술논문

目的：总结复杂尿瘘的治疗经验,探讨一种可以应用于复杂尿瘘的新的诊治方法。方法：对同时行膀胱癌Bricker 术和直肠癌Hart mann 术且术后出现漏尿的患者,在常规输尿管镜检查无法进行且B 超、I VU、CT、MRU 等手段无法明确瘘口位置的情况下,尝试在DS A 机透视下经瘘道插管造影,明确瘘口位于输尿管下段,然后行患侧肾脏穿刺造瘘并经造瘘处顺行置入双J 管,以期治愈尿瘘、保护患侧肾脏功能。结果：治疗后瘘口愈合,随访半年,查肾功能正常,B 超示患肾无明显积水。结论：经瘘道插管造影联合输尿管内顺行置管法避免了再次手术且保留了患侧的肾脏功能,适用于复杂尿瘘的诊断和治疗,尤其适用于无法明确瘘口位置的患者。
목적：총결복잡뇨루적치료경험,탐토일충가이응용우복잡뇨루적신적진치방법。방법：대동시행방광암Bricker 술화직장암Hart mann 술차술후출현루뇨적환자,재상규수뇨관경검사무법진행차B 초、I VU、CT、MRU 등수단무법명학루구위치적정황하,상시재DS A 궤투시하경루도삽관조영,명학루구위우수뇨관하단,연후행환측신장천자조루병경조루처순행치입쌍J 관,이기치유뇨루、보호환측신장공능。결과：치료후루구유합,수방반년,사신공능정상,B 초시환신무명현적수。결론：경루도삽관조영연합수뇨관내순행치관법피면료재차수술차보류료환측적신장공능,괄용우복잡뇨루적진단화치료,우기괄용우무법명학루구위치적환자。
Objective:To discuss a new method for the diagnosis and treatment of complex urinary fistula by summarizing our successful experiences .Methods:An old patient who had bladder carcinoma and rectal cancer con-currently got leakage of urine after the procedures including Bricker operation and Hart mann operation si multaneous-ly.Firstly,thepreciselocationoftheorificiumfistulae wasdefinitedbyintubationandvisualizationthroughthefis-tuloustractatthecircumstanceof DSAfluoroscopy;thenpuncturationandfistulizationwereoperated;finally,one double-J catheter was put into i mpaired ureter .Results:Urinary fistula was cured after these procedures .Renal func-tion and ultrasound figure of the patient was nor mal half a year later .Conclusions:This method could be applied to curecomplicatedurinaryfistula,especiallyforpatients whoselocationoforificiumfistulaecouldnotbefound.