【摘要】：目的探討雙層縫合技術(shù)("圍堰")及球海綿體肌脂肪墊移植("堵瘺")在復(fù)雜膀胱陰道瘺修補(bǔ)術(shù)中的應(yīng)用價值。方法 2010年1月~2015年12月,采用雙層縫合技術(shù)("圍堰")及球海綿體肌脂肪墊移植("堵瘺")方法對6例復(fù)雜膀胱陰道瘺患者實(shí)施經(jīng)陰道修復(fù)手術(shù)。4例瘺口1.5 cm。4例瘺口位置高(近輸尿管口)。4例有修復(fù)失敗史。經(jīng)陰道瘺口插入尿管至膀胱并充盈水囊,顯露并支撐瘺口,雙層縫合膀胱關(guān)閉瘺口;球海綿體肌脂肪墊移植加強(qiáng)瘺口。術(shù)后留置尿管2周。結(jié)果 6例手術(shù)全部一次修復(fù)成功。術(shù)后平均隨訪28個月(3~60個月),均未發(fā)現(xiàn)漏尿。結(jié)論雙層縫合技術(shù)("圍堰")及球海綿體肌脂肪墊移植("堵瘺")處理復(fù)雜膀胱陰道瘺成功率高。
[Abstract]:Objective to investigate the application value of double suture technique (cofferdam) and bulbar cavernous muscle fat pad ("occluding fistula") in the repair of complex vesicovaginal fistula. Methods from January 2010 to December 2015, Double suture technique ("cofferdam") and bulbar cavernous muscle fat pad transplantation ("fistula") were used to repair 6 patients with complicated vesicovaginal fistula. The fistula was repaired by transvaginal repair in 4 patients (1.5 cm.4) with a high fistula position (near ureter orifice). 4 cases had a history of failure. The vaginal fistula was inserted into the bladder and filled with water sac, the fistula was exposed and supported, the fistula was closed by double suture, and the fistula was strengthened by the transplantation of bulbous cavernous muscle fat pad. Postoperative indwelling urethral catheter for 2 weeks. Results all 6 cases were repaired successfully at one time. The average follow-up was 28 months (3-60 months), and no leakage of urine was found. Conclusion double-layer suture (cofferdam) and bulbar cavernous muscle fat pad transplantation ("plugging fistula") have a high success rate in the treatment of complicated vesicovaginal fistula.
【作者單位】： 深圳大學(xué)附屬羅湖醫(yī)院女性生殖道畸形診療中心婦科盆底�？�;
【基金】：深圳市衛(wèi)生計生委科技計劃項目(201601055)
【分類號】：R699

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