魏振杰 郭丰桐 高媛媛 赵艳丽

输尿管导管在妇科腹腔镜手术中预防输尿管损伤的应用

魏振杰 郭丰桐 高媛媛 赵艳丽

目的 观察和探讨输尿管导管在妇科腹腔镜手术中预防输尿管损伤的应用价值。方法 选择于2013年1月～2015年1月我院收治的120例妇科腹腔镜手术患者作为研究对象，随机分为两组，观察组和对照组，每组60例患者。观察组患者，术前放置双侧输尿管导管，术中在腹腔镜下进行手术，术后立即拔除导管；对组组患者在腹腔镜下进行手术，但术前未行输尿管插管。观察对比两组患者的输尿管损伤情况，手术一般情况以及并发症的发生。结果 观察组患者无输尿管损伤，手术结束后即拔除输尿管导管，术后出现稍微淡红色肉眼血尿，所有患者均无不良反应的发生。对照组患者输尿管损伤率为 13.33%。观察组的输尿管损失率均显著低于对照组（P ＜0.05），两组比较有统计学意义。观察组患者的术中出血量，手术时间，住院天数以及并发症等均显著低于对照组，并且具有显著差异（P＜0.05）。结论 手术前放置输尿管导管可降低妇腹腔镜手术中输尿管损伤的几率，缩短手术时间，减少术中出血量，住院时间并且降低并发症的发生。

输尿管导管，输尿管损伤，妇科腹腔镜手术

【Abstract】

Objective To observe and investigate the value of ureteral catheter in the prevention of ureteral injury under gynecologic laparoscopic surgery. Methods We selected 120 cases of gynecological laparoscopic surgery who were treated in our hospital from January 2015 to January 2013 as the research subjects， they were randomly divided into two groups， the observation group and the control group， each group had 60 cases. For the observation group， the patients were placed on the bilateral ureteral catheter before operation， and the catheter was removed immediately after laparoscopic operation. The ureteral injury， surgery and the occurrence of complications of the two groups were compared. Results There were no ureteral injury and adverse events in the observation group. After the operation，the ureter catheter was removed， and the appearance of the light red eyes was observed.The ureteral injury rate of the control group was 13.33%. The loss rate of the observation group was significantly lower than that of the control group， there were statistically significant（P＜0.05）. The amount of bleeding， operation time， length of hospital stay， and complications of the observation group were significantly lower than those of the control group， and tere were significant difference （P＜0.05）. Conclusion Placement of ureteral catheter before operation can reduce the risk of ureteral injury， shorten the operation time， reduce the amount of bleeding， hospitalization time and reduce the incidence of complications.

【Key words】Ureteral catheter，Ureteral injury，Gynecological laparoscopic surgery

输尿管为一细长而有肌肉黏膜构成的管形器官，位于腹膜后间隙，管周有良好的保护并有一定活动范围，因此由外界暴力所致成的输尿管损伤殊为少见；但在输尿管内进行检查操作和广泛性盆腔手术时常引起输尿管损伤［1-2］。……