摘要
目的:探讨改良经阴道和经腹术式治疗膀胱阴道瘘的临床疗效。方法:回顾性分析2014年3月—2019年9月广西医科大学附属第四医院诊治的14例膀胱阴道瘘患者的临床资料。分析14例患者的手术方法、手术时间、住院时间和术中出血量。结果:9例患者行改良经阴道途径膀胱阴道瘘修补术,平均手术时间(106.9±29.4)min,平均住院时间(7.2±2.8)d,平均术中出血(9.2±7.3)ml。1例患者术后1个月复发,二次行经阴道途径修补术后随访6个月未见复发,其余患者术后随访6个月均未复发。5例行开放经腹途径膀胱阴道瘘修补术,平均手术时间(247±22.7)min,平均住院时间(13.6±2.3)d,平均术中出血(187.2±55.1)ml。其中1例经腹手术患者术后2个月再次出现漏尿,二次手术行改良经阴道途径修补,随访6个月未见复发,1例术后出现伤口脂肪液化。所有患者均获得随访,随访时间范围3~9个月。结论:改良经阴道途径修补膀胱阴道瘘相对于经腹修补具有创伤小、手术时间短、住院天数少和并发症少等优点,是一种安全有效的微创术式。
Objective:To compare the clinical efficacy of modified transvaginal and transabdominal procedures in the treatment of vesicovaginal fistula.Methods:From March 2014 to September 2019,the clinical data of 14 patients with vesicovaginal fistula undertaken vesicovaginal fistula repair in the hospital were analyzed.The operation method,operation time,hospitalization time and intraoperative blood loss of 14 patients were analyzed.Results:9 patients underwent modified transvaginal vesicovaginal fistula repair,the average time of surgery was(106.9±29.4)min,the average hospital stay was(7.2±2.8)d,the average intraoperative blood loss was(9.2±7.3)ml.One patient relapsed 1 month after the operation.The second transvaginal repair was followed up for 6 months without recurrence.The remaining patients did not relapse after 6 months of follow-up.5 cases underwent open transabdominal vesicovaginal fistula repair.The average operation time was(247±22.7)min,the average hospital stay was(13.6±2.3)d,and the average intraoperative blood loss was(187.2±55.1)ml.Among them,1 patient who underwent transabdominal repair had urine leakage again 2 months after operation,secondary repair with modified transvaginal approach was performed,and no recurrence was found in the follow-up 6 months.And 1 case had wound fat liquefaction after operation.The postoperative follow-up time ranged from 3 to 6 months.Conclusion:Compared with transabdominal repair,the modified transvaginal repair of vesicovagi-nal fistula has the advantages of less trauma,shorter operation time,less hospital stay and less complications.It is a safe and effective minimally invasive operation.
作者
谢华栋
陈光
詹谊
管刚云
罗建仕
蒙勇燕
曾四平
XIE Hua-dong;CHEN Guang;ZHAN Yi(Department of Urology,Fourth Affiliated Hospital of Guanxi Medical University,Liuzhou,Guangxi,545005,China)
出处
《黑龙江医学》
2021年第9期901-903,906,共4页
Heilongjiang Medical Journal
基金
广西壮族自治区卫生健康委员会自筹经费课题(Z20190243)。
关键词
膀胱阴道瘘
经阴道修补术
经腹修补术
改良
Vesicovaginal fistula
Transvaginal repair
Transabdominal repair
Modified
