论文部分内容阅读
为了使肾移植后尿瘘诊断更加规范,根据肾移植后尿瘘诊断分类的标准,将解放军第三军医大学大坪医院野战外科研究所泌尿外科1993-12/2008-10肾移植1313例中术后发生尿瘘68例患者进行分类。按照尿瘘病变程度分为单纯性和复杂性两大类,按照尿瘘的病因及部位分为低位瘘、高位瘘和多发瘘。68例肾移植后尿瘘中,单纯性尿瘘47例,占69.1%,其中输尿管末端坏死42例;输尿管膀胱吻合口缝合不严4例;伤口感染致吻合口愈合不良1例。复杂性尿瘘21例,占30.9%。尿瘘瘘口部位:肾盂2例,输尿管2例,输尿管膀胱吻合口11例,输尿管坏死段>2cm6例。手术修补次数:1次11例,2次5例,3次3例,4次2例。死亡2例,占2.9%,死亡原因为尿瘘导致重症肺部感染。提示:将肾移植后尿瘘分为单纯性和复杂性尿瘘两大类的优点是,一是使尿瘘诊断更加细致及规范化;再是选择最佳的治疗方案,达到最好治疗效果。
In order to make the diagnosis of urinary fistula after renal transplantation more standardized, according to the standard of diagnosis and classification of urinary fistula after renal transplantation, urinary fistula was found in 1313 cases of postoperative renal transplantation in Department of Urology, Daping Hospital of PLA Third Military Medical University, 1993-12 / 2008-10 68 patients were classified. According to the degree of urinary fistula lesions are divided into two categories of simplicity and complexity, according to the etiology and location of urinary fistula is divided into low fistula, high fistula and multiple fistula. In 68 cases of post-transplant urinary fistulas, 47 cases were simple urinary fistulas, accounting for 69.1%, including 42 cases of distal ureteric necrosis; 4 cases of ureteric anastomosis sutureless laparotomy; 1 case of anastomotic poor wound healing. Complex urinary fistula in 21 cases, accounting for 30.9%. Fistula fistula site: 2 cases of renal pelvis, ureter in 2 cases, ureteral anastomosis in 11 cases, ureteral necrosis> 2cm6 cases. Surgical repair times: 1 in 11 cases, 2 in 5 cases, 3 times in 3 cases, 4 times in 2 cases. 2 died, accounting for 2.9%, the cause of death was urinary fistula leading to severe pulmonary infection. Tip: The renal transplantation after the fistula is divided into simple and complex two major advantages of urinary fistula is that one is to make the diagnosis of urinary fistula more detailed and standardized; then select the best treatment to achieve the best therapeutic effect.