经尿道输尿管扩张术治疗输尿管下段狭窄112例临床分析.docVIP

经尿道输尿管扩张术治疗输尿管下段狭窄112例临床分析【摘要】 目的 探讨经尿道输尿管扩张治疗输尿管下段狭窄的临床效果。方法 采用经尿道输尿管扩张治疗输尿管下段狭窄112例，其中男65例，女47例，平均年龄38岁。狭窄段长度0.5~0.2 cm。结果 112例均顺利通过输尿管扩张导丝，狭窄段扩张成功。随访6~30个月，平均13个月。一次扩张成功96例（85.7%），B超提示肾盂积水均消失或明显减轻，CTU示狭窄段通畅；其中2例先天性巨输尿管症术后取支架后狭窄复发，肾盂积水无明显改善，经再次扩张和置入双“J”管后，肾积水减轻，狭窄段较前通畅；所有手术无输尿管穿孔、脱套、撕裂等严重并发症发生。结论 经尿道输尿管扩张治疗输尿管下段狭窄具有操作简单、效果可靠、并发症少、体表无伤口、可重复治疗及住院时间短等优点。? 【关键词】 输尿管狭窄； 输尿管镜； 输尿管扩张器?? Clinical analysis of 112 patients with lower ureter stenosis treatad by transurethral ureteral dilataion ?SUN Guo-hua,NING Fang-xia.The Medical School of Qingdao University,Qingdao 266071,China?? 【Abstrsct】 Objective To investigate the clinical effect of the transurethral ureteral dilatation in the treatment of lower ureter stenosis.Methods 112 patients with lower ureter stenosis were treated by transurethral ureteral dilatation.There were 65 male and 47 female with the mean age of 38 years old.The lengths of the narrow segments were 0.5~2.0 cm.Results In all of the 112 cases,the guide wire of the ureteral dilator passed through the narrow segment smoothly.All the patients were successfully dilated.Follow-up lasted for 6~30 months,average 13 months.96 cases were successfully dilated by single operation (85.7%).B ultrasonic showed that the hydronephrosis disappeared or reduced significantly,CTU showed the narrow segment is unobstructed.2 cases with Congenital Megaureter turned up restenosis after the double J stents were removed,the hydronephrosis was not improved significantly neither.After dilatation and putting into double“J”tubes for another time,the hydronephrosis was alleviated,the narrow segments were more clear than before.There was no ureteral perforation,degloving injury,tear and other severe complication in all of the operation.Conclusion The advantages of transurethral ureteral dilatation in the treatment of lower ureter stenosis include simplicity of operation,reliable efficacy,no visible surgical incision in boby surface,repeatedly performable process and short hospi