【摘要】 目的　探讨妇科手术中输尿管损伤的易发因素与预防 ;以期及早发现与诊治。方法　对北京大学第一医院 1 997年 1月～ 2 0 0 2年 3月间妇科手术中的 1 2例输尿管损伤病例进行回顾性分析总结。结果　妇科开腹手术共 75 84例 ,其中并发输尿管损伤 1 0例 ,占 0 1 1 % ;腹腔镜手术共 6 5 1例 ,发生输尿管损伤 2例 ,占0 31 %。 1 2例输尿管损伤均为单侧损伤 ,其中左侧损伤 7例 ;5例损伤在近膀胱处、 5例在子宫动静脉附近、 2例在漏斗韧带附近。结论　妇科手术致输尿管损伤多见于左侧输尿管损伤 ,且以宫颈癌病例居多 ;腹腔镜手术开展的同时应警惕输尿管损伤的发生。对于困难手术 ,术前可行静脉尿路造影和预置输尿管支架。术后重视腹胀、排气延迟、腹水等异常表现 ,及时发现输尿管损伤并积极处理更多还原

【Abstract】 Objective To study the reason,therapy and prevention of ureteral injury in gynecologic surgery Methods Twelve cases of ureteral injury in gynecologic surgery during 1997 1～2002 3 were analyzed retrospectively Results The rate of ureteral injury was 0 11% in laparotomic surgery and 0 31% in laparoscopic ones All cases were unilateral injuries,7 of which were on the left Five cases were injured near bladder,5 near uterine vessels and 2 near funnel ligament Conclusions Ureteral injury occurs more often in cervical cancer surgeries and should be cautioned in laparoscopy It is important to prevent this complication in gynecologic surgery,as well as to diagnose and treat timely and properly更多还原