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1 病例报告 患者女,49岁,1992年3月2日因“子宫肌瘤”入院。检查子宫如孕2个月,宫颈Ⅲ肥大。3月12日行子宫全切除术。手术称顺利。术后当晚诉右腰痛,第二天追询曾有“右肾下垂”病史。有类似腰痛,故未引起重视。术后第15天B超提示右肾增大为12.8×6.5cm。右肾积水(液性暗区2.0cm).腹平片未见结石。术后28天ⅣP示右肾下显影.膀胱镜检查右输尿管口不喷尿.逆行插管右侧进入7cm受阻,造影剂受阻。右肾图呈抛物线型,功能中度受损。血BUN5.9mmol/L.Cr110μmol/L。诊断:右输尿管下段梗阻。术后58天行右输尿管下段手术探查.术中见平右髂前上棘稍下方输尿管有2条黑丝线贯穿缝扎。完全闭塞(未切断),其上方输尿管扩张,拆除缝扎线节,尿液仍不能通过、故切除狭窄段输尿管约1cm,上段有清亮尿液流出,用8号导尿管上下探查输尿管均通畅,放入支架管,常规端端吻合输尿管。
A case report Female patient, 49 years old, March 2, 1992 due to “uterine fibroids” admitted. Check the uterus, such as pregnancy 2 months, cervical hypertrophy Ⅲ. March 12 line hysterectomy. Surgery called smooth. The right night complained of right back pain after surgery, the second day there had been “history of right kidney droop”. Similar to low back pain, it did not attract attention. On the 15th day after operation, B-mode ultrasound showed that the right kidney increased to 12.8 × 6.5cm. Right hydronephrosis (liquid dark area 2.0cm). Abdominal plain film no stones. 28 days after IVP showed right renal subrenal cystoscopy right ureteral orifice does not spray urine retrograde intubation right into the 7cm blocked, contrast agent blocked. Right kidney diagram was parabolic, moderately impaired function. Blood BUN 5.9mmol / L.Cr110μmol / L. Diagnosis: lower right ureter obstruction. 58 days after surgery right lower ureteral surgery exploration. See the right anterior superior iliac spine in the surgery a little below the ureter has 2 black thread through the suture. Complete occlusion (not cut off), the ureter above its expansion, remove the suture section, the urine still can not pass, so the removal of the narrow section of the ureter about 1cm, the upper part of the clear urine outflow, with catheter up and down exploration of the ureter were open , Into the stent tube, conventional end anastomosis ureter.