输尿管镜联合钬激光辅助等离子体汽化治疗复杂性尿道狭窄16例临床分析.docVIP

输尿管镜联合钬激光辅助等离子体汽化治疗复杂性尿道狭窄16例临床分析 　　【摘要】 目的：探讨输尿管镜联合钬激光辅助等离子体汽化治疗复杂性尿道狭窄的疗效。方法：本组16例患者均为复杂性尿道狭窄，均以输尿管镜辅助建立标记或以钬激光建立通道，以等离子体刀进行瘢痕汽化进一步扩大尿道腔，直至电切镜鞘通过狭窄段，最后留置F20#三腔尿管三周，拔除尿管后定期扩张。结果：16例患者经治疗后均予以定期尿道扩张，随访1～9年，均恢复正常排尿。结论：输尿管镜及钬激光辅助等离子电切镜治疗可以大大提高手术成功率，通道或标记建立后应当尽量采取等离子汽化治疗，可提高患者的远期疗效。 　　【关键词】 输尿管镜； 钬激光； 复杂性尿道狭窄 　　中图分类号 R695 文献标识码 B 文章编号 1674-6805（2014）3-0032-02 　　Clinical Analysis of Plasma Vaporization Assisted by Ureteroscopy and Holmium Laser in the Treatment of 16 Cases with Complicated Urethrostenosis/BING Jian-yong，XI Xiao-long，ZHANG Zi-gang，et al.//Chinese and Foreign Medical Research，2014，12（3）：32-33 　　【Abstract】 Objective：To study the clinical effect of plasma vapourization assisted by ureteroscope and holmium laser in the treatment of complicated urethrostenosis.Method：A total of 16 patients with complicated urethrostenosis were selected， and all patients used ureteroscope to set marks or holmium to set path， and researchers used plasmato vapourize scars in order to enlarge urethra， and a F20 catheter was detained 3 weeks， and urethral sounding would be used regularly when catheter was removed.Result：All of 16 patients were given urethral sounding regularly after the treatment and followed up from 1 to 9 years.All patients recovered to urinate normally.Conclusion：Plasma electrotomyoscope assisted by ureteroscope and holmium can raise the success rate of the operation， and plasma vapourization is suggested to be used after the establishment of path or mark， which can raise patient’s long-term effect. 　　【Key words】 Ureteroscope； Holmium； Complicated urethrostenosis 　　First-author’s address：Daqing Oilfield General Hospital，Daqing 163001，China 　　复杂性尿道狭窄是指严重尿道狭窄或闭锁，多由尿道损伤、医源性损伤、尿道感染等引起，其治疗是泌尿外科领域中的一个较大的难题[1]。应用输尿管镜及钬激光联合等离子电切术治疗尿道狭窄结合了两种腔镜技术的优点，优势互补。本研究利用输尿管镜及钬激光辅助下等离子体汽化电切治疗复杂性尿道狭窄16例，效果较好，现报告如下。 　　1 资料与方法 　　1.1 一般资料 　　2002年至今笔者所在医院共治疗16例复杂性尿道狭窄患者，均为男性；年龄16～72岁，平均41.5岁；所有患者术前均行逆顺行尿道造影及尿液动力学检查，了解狭窄部位和长度。术前自由尿流率（8.1±3.2）ml/s。前列腺术后尿道狭窄4例，外伤后复杂尿道狭窄11例，慢性炎