直肠癌手术合并输尿管损伤的原因分析及应对策略(1)
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[摘要] 目的 探讨直肠癌手术合并输尿管损伤的原因及应对策略。 方法 回顾性分析我院收治的54例直肠癌手术合并输尿管损伤患者的临床资料。 结果 将本研究发现的导致直肠癌手术合并输尿管损伤的原因分别定义为原因A、B、C、D，上述4个原因的发生率不全相等(P < 0.05)，原因A的发生率显著高于原因B、C、D(P < 0.05)，原因B、C的发生率相比差异无统计学意义(P > 0.05)，原因B、C的发生率显著高于原因D(P<0.05)。4组患者在随访期内的尿路狭窄发生率相比差异无统计学意义(P > 0.05)。 结论 大块钳夹、切断肠系膜下动脉或者在其左侧结扎肠系膜下静脉时误伤输尿管是直肠癌手术合并输尿管损伤最主要的原因。经相关处理，直肠癌手术合并输尿管损伤的预后良好。
[关键词] 直肠癌；输尿管损伤；原因分析
[中图分类号] R735.3 [文献标识码] B [文章编号] 1673—9701(2012)25—0147—02
Rectal cancer surgery combined ureteral injury causes and coping strategies
XIANG Mingsong
Department of General Surgery，the Second People's Hospital of Huaihua City in Hunan Province，Huaihua 418200，China
[Abstract] Objective To investigate rectal cancer surgery with ureteral injury causes and coping strategies. Methods A retrospective analysis of 54 cases of rectal cancer surgery hospital to merge clinical data of patients with ureteral injury. Results This study found lead to rectal cancer surgery combined ureteral injury causes are defined separately for reasons A， B， C and D，of the reasons the incidence of the above four reasons are not all equal (P < 0.05)，because A incidence was significantly higher than reason B，C and D (P < 0.05)，there was no sighifrciant differentce between the incidence of the reasons B and C (P > 0.05)，the incidence of reason A was significant higher than the reason D(P <0.05). Four patients in the follow—up period，urinary tract stenosis incidence compared the difference was not statistically significant(P > 0.05). Conclusion The large jaws，cut off the inferior mesenteric artery or the left side of the ligation of the inferior mesenteric vein accidentally injure the ureter is the most important reason of rectal surgery with ureteral injury. By the relevant treatment，the prognosis of rectal cancer surgery combined ureteral injury.
[Key words] Rectal cancer；Ureteral injury；Causes analysis ......
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