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目的:探析妇科手术导致膀胱、输尿管阴道瘘的原因及防治措施。方法:选我院膀胱、输尿管阴道瘘患者28例,回顾性分析输尿管、膀胱阴道瘘患者的诊治情况。结果:18例膀胱阴道瘘患者中16例为阴道途径修补,2例因复杂性瘘管经腹部修补;16例患者一次性修补成功,2例病人二次修补成功。输尿管阴道瘘病人10例中4例形成尿瘘早期顺利完成输尿管插管术,5例于形成尿瘘后3~6个月予以输尿管膀胱再植术顺利完成,1例经抗感染支持疗法后治愈。结论:输尿管、膀胱阴道瘘适宜形成尿瘘后3~6个月进行手术疗法,输尿管阴道瘘患者可先行抗感染支持或输尿管插管术疗法,膀胱阴道瘘患者多数可经阴道途径修补,若上述疗法无效,可再行输尿管膀胱再植术。
Objective: To investigate the causes of gynecological surgery leading to vaginal fistula of bladder and ureter and its prevention and treatment. Methods: 28 cases of bladder and ureteric fistula were selected in our hospital. The diagnosis and treatment of ureter and vesicovaginal fistula were retrospectively analyzed. Results: Of the 18 cases with vesico-vaginal fistula, 16 cases were repaired by the vaginal approach, 2 cases were complicated by fistula by abdominal repair, 16 cases were repaired successfully and 2 cases were repaired successfully. Ureteral fistula patients 10 cases in 4 cases of early formation of urinary fistula successfully ureteral intubation, 5 cases of urinary fistula after 3 to 6 months to be ureteral bladder replantation was successfully completed, 1 case of anti-infective supportive therapy after cure. Conclusions: Ureter and vesico-vaginal fistulas are suitable for surgery 3 to 6 months after the formation of urinary fistula. Patients with ureteric fistula can be given anti-infective support or ureteral intubation. Most patients with vesico-vaginal fistula can be repaired by vaginal route. Invalid, re-ureteric bladder replantation.