中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2014年
8期
606-610
,共5页
泌尿系统损伤%肾%输尿管%膀胱%尿道
泌尿繫統損傷%腎%輸尿管%膀胱%尿道
비뇨계통손상%신%수뇨관%방광%뇨도
Urological trauma%Kidney%Ureter%Bladder%Urethra
目的 总结泌尿系统损伤的诊治经验.方法 回顾性分析2002年3月至2012年3月收治的162例肾、输尿管、膀胱、尿道损伤患者的诊治方法及治疗结果.结果 162例经治疗均恢复顺利出院.62例肾损伤患者行保守治疗45例、超选择性肾动脉造影栓塞术9例、肾切除术8例,随访3～ 24个月肾功能均正常.2例输尿管损伤患者行膀胱镜下输尿管置管和输尿管膀胱再植术各1例,术后随访1年,B超检查均未提示患侧肾积水.6例膀胱损伤患者均采用膀胱修补术,术后随访6～12个月排尿均无异常.92例尿道损伤患者行单纯导尿6例、尿道会师术18例、膀胱镜下尿道会师术35例、尿道修补术4例、尿道端端吻合术29例,拔管后随访6 ～ 24个月,29例(32％)发生尿道狭窄,后期行进一步处理.结论 泌尿系统损伤临床多见,早期诊断和治疗十分重要,多数患者经积极治疗可获得满意的疗效,部分患者出现后期并发症,需进一步治疗.
目的 總結泌尿繫統損傷的診治經驗.方法 迴顧性分析2002年3月至2012年3月收治的162例腎、輸尿管、膀胱、尿道損傷患者的診治方法及治療結果.結果 162例經治療均恢複順利齣院.62例腎損傷患者行保守治療45例、超選擇性腎動脈造影栓塞術9例、腎切除術8例,隨訪3～ 24箇月腎功能均正常.2例輸尿管損傷患者行膀胱鏡下輸尿管置管和輸尿管膀胱再植術各1例,術後隨訪1年,B超檢查均未提示患側腎積水.6例膀胱損傷患者均採用膀胱脩補術,術後隨訪6～12箇月排尿均無異常.92例尿道損傷患者行單純導尿6例、尿道會師術18例、膀胱鏡下尿道會師術35例、尿道脩補術4例、尿道耑耑吻閤術29例,拔管後隨訪6 ～ 24箇月,29例(32％)髮生尿道狹窄,後期行進一步處理.結論 泌尿繫統損傷臨床多見,早期診斷和治療十分重要,多數患者經積極治療可穫得滿意的療效,部分患者齣現後期併髮癥,需進一步治療.
목적 총결비뇨계통손상적진치경험.방법 회고성분석2002년3월지2012년3월수치적162례신、수뇨관、방광、뇨도손상환자적진치방법급치료결과.결과 162례경치료균회복순리출원.62례신손상환자행보수치료45례、초선택성신동맥조영전새술9례、신절제술8례,수방3～ 24개월신공능균정상.2례수뇨관손상환자행방광경하수뇨관치관화수뇨관방광재식술각1례,술후수방1년,B초검사균미제시환측신적수.6례방광손상환자균채용방광수보술,술후수방6～12개월배뇨균무이상.92례뇨도손상환자행단순도뇨6례、뇨도회사술18례、방광경하뇨도회사술35례、뇨도수보술4례、뇨도단단문합술29례,발관후수방6 ～ 24개월,29례(32％)발생뇨도협착,후기행진일보처리.결론 비뇨계통손상림상다견,조기진단화치료십분중요,다수환자경적겁치료가획득만의적료효,부분환자출현후기병발증,수진일보치료.
Objective To summarize the diagnosis and treatment of urological trauma.Methods One hundred and sixty-two patients with trauma of kidney,ureter,bladder or urethra were treated between March 2002 and March 2012.The diagnosis,treatment and outcome were analyzed.Results All patients were discharged with improved condition.Of 62 patients with renal injury,45 were treated with conservative approach,9 were treated with superselective arterial embolization,and 8 were treated with nephrectomy.All the 62 patients had normal renal function during the follow-up period of 3 to 24 months.Of 2 patients with ureteral injury,one was treated with cystoscopic ureteral catheterization,and another one with ureteric reimplantation.Neither of the 2 patients developed hydronephrosis during the one year follow-up period.All 6 patients with vesical injury were treated with open surgery,and they all had normal urinary function during the follow-up period of 6 to 12 months.Of 92 patients with urethral injury,6 were treated with urethral catheterization,18 with urethral realignment,35 with cystoscopic urethral realignment,4 with urethral repairment,and 29 with end-to-end anastomotic urethroplasty; 29 (32％) patients suffered from urethral stricture during the follow-up period of 6 to 24 months,and they underwent further treatment.Conclusions Urological trauma is quite frequent,and early diagnosis and treatment is important.Good outcomes will be achieved in most of patients by suitable treatments,but complications which need further treatments may occur subsequently in part of the patients.
