输尿管镜下气压弹道碎石术治疗输尿管结石出现的常见并发症及其防治对策.docVIP

精品论文 参考文献 输尿管镜下气压弹道碎石术治疗输尿管结石出现的常见并发症及其防治对策 （附 1629例报道） 　　姜小琴1,2 肖民辉2 申杰2(通讯作者) 　　（1大理大学临床医学院 云南 大理 671000） 　　（2云南省第一人民医院 云南 昆明 650000） 　　【摘要】 目的：总结经尿道输尿管镜下气压弹道碎石取石术出现的常见并发症及其防治对策 方法：对我院泌尿外科2003年5月-2014年10月应用输尿镜下气压弹道碎石取石术治疗输尿管结石出现并发症的病例（198例）进行分析。男性1208例，女性421例；平均年龄40.5岁。结石有726例位于输尿管下段，668例位于输尿管中段，235例位于输尿管上段。结果：本组1629例输尿管镜下气压弹道碎石取石术，一次性碎石成功率91.8%（1496/1629），出现并发症198例, 其中结石移位至肾盂69例及结石残留需行ESWL等辅助治疗75例，输尿管穿孔26例，输尿管粘膜损伤20例，断裂1例，术后输尿管狭窄4例，输尿管粘膜撕脱3例。结论：输尿管上段结石的并发症明显高于中下段，嵌顿性结石的并发症也明显增高。经尿道输尿管镜气压弹道碎石术创伤小，碎石准确，安全性高。术中术后并发症的发生与输尿管的解剖及手术者的技术操作密切相关，熟悉输尿管的解剖合理运用技术处理术中情况，严格掌握手术指征，提高术中手术技巧，可有效减少手术并发症，提高手术成功排净结石率。 　　【关键词】 输尿管结石；输尿管镜气压弹道碎石术；并发症 　　【中图分类号】R693+.4 【文献标识码】A 【文章编号】2095-1752（2015）20-0182-02 　　Management of common complications of transureteroscopic pneumatic lithotripsy for treating ureter calculi (with 1629 cases reported) 　　Jiang Xiaoqin,Xiao Minhui,Shen Jie 　　(1,Clinical Medical College of DALI University 617000 2,Department of Urology,the first peoples hospital of YunNan Province, Kunming, Yunnan 650032). 　　【Abstract】 Objective To summarize the precautionary measures and the common complications of transureterscopic pneumatic lithotripsy. Methods 1629 cases of ureter calculi from May 2003 to October 2014 in our hospital were applicated for the treatment of transureterscopic pneumatic lithotripsy,through which 198 cases of complications were analyzed. 1208 male and 421 female cases,mean age 40.5 years.726 patients had calculi in the lower ureter, 668 cases in the middle ureter,and 235 cases in the upper ureter. Results The overall comminution rate was 91.8% (1496/1629 cases), 198 cases of complications, including shift to 69 cases of the renal pelvis and stones to ESWL and other auxiliary treatment of 75 cases of residual,26 cases of ureteral perforation, 20 cases of ureteral damage, fracture in 1 case, postoperative ureteral stricture, 4 cases of ureteral mucosa avulsion in 3 cases.Conclusion Ureteral Duan Jieshi com