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目的探讨后腹膜包裹法治疗输尿管长段撕脱伤的手术方法和效果。方法 2006年1月～2009年12月,我科共诊治5例输尿管镜取石术中并发输尿管长段撕脱伤患者,均采用输尿管置内支架管,5-0可吸收缝线间断缝合输尿管断端恢复输尿管连续性,后腹膜全程包裹输尿管,输尿管内支架3个月后拔除。结果 1例患者拔除输尿管内支架管并发伤侧肾轻度积水,随访1年肾积水无加重;4例患者拔除输尿管内支架管后伤侧肾积水较术前均减轻,随访肾积水无加重。无伤侧肾感染患者。结论后腹膜包裹法可作为治疗输尿管长段撕脱伤的一种手术方式。由于病例数少,随访时间短,有待进一步的临床研究明确该手术方式优势和长期效果。
Objective To investigate the surgical method and effect of retroperitoneal parotomy in the treatment of long ureteral avulsion injury. Methods From January 2006 to December 2009, 5 cases of patients with ureteral long-term avulsion were treated by ureteroscopic lithotomy in our department. All patients underwent ureteral stent-graft and 5-0 absorbable sutures interrupted suturing of ureter Ureterminal restoration of the continuity of the peritoneal whole package ureter, ureteral stent removed after 3 months. Results One case of patients with ureteral stent-graft complicated with mild hydronephrosis of the injured side had no aggravate hydronephrosis at 1-year follow-up. The hydronephrosis of the injured side after 4 cases of extubation of ureter was relieved compared with that before operation, No increase in water. No injuries in patients with kidney infection. Conclusion The peritoneal approach can be used as a surgical method for the treatment of long-term avulsion of the ureter. Due to the small number of cases and short follow-up period, further clinical studies are needed to clarify the advantages and long-term effects of the operation.