输尿管镜结合钬激光治疗输尿管狭窄153 例临床观察.docVIP

精品论文 参考文献 输尿管镜结合钬激光治疗输尿管狭窄153 例临床观察 李海源 刘孝东 赵晖 申吉泓（通讯作者） 　　（昆明医科大学第一附属医院泌尿外科 云南昆明 650000） 　　【摘要】目的：讨论腔内泌尿外科手术治疗输尿管狭窄的疗效和安全性。方法：对153例采用腔内泌尿外科技术结合钬激光治疗的输尿管狭窄患者资料进行回顾性分析。结果：对153例患者采用不同的腔内输尿管腔内技术治疗，其中：输尿管镜下直视镜身扩张125例，钬激光内切开28例。所有病例均一次手术成功，成功率100%。术后有3例输尿管狭窄患者肾积水复发，重复留置双 J 管引流后治愈。结论：利用腔内泌尿外科技术结合钬激光处理输尿管狭窄安全有效。较短的输尿管狭窄使用输尿管镜直视下扩张术效果良好；较长较严重的输尿管狭窄应使用钬激光内切开结合输尿管镜直视下扩张术。术后放置双 J管引流及慢性扩张效果更好。 　　【关键词】输尿管狭窄；输尿管镜；钬激光 　　【中图分类号】R69 【文献标识码】A 【文章编号】1007-8231（2016）05-0133-02 　　 Clinical Observation of 153 Cases of Ureteral Stricture Dealt with Ureteroscopic Technique and Holmium Laser 　　 Li Haiyuan, Liu Xiaodong, Zhao Hui, Shen Jihong(Correspondence author) 　　【Abstract】Objective To discuss the efficacy and safety of endourological surgical treatment of ureteral stricture. Methods 153 cases with ureteral stenosis underwent endourological treatment combined with holmium laser were retrospectively analyzed. Results 153 patients were treated with various intraluminal ureter treatment technology: ureteroscopic expansion for 125 cases, holmium laser incision with ureteroscopic expansion for 28 cases . The success rate was 100%. There are 3 cases of postoperative ureteral stricture recurrence with hydronephrosis, repeated double J tube indwelling cured them. Conclusion Endourological treatment combined with holmium laser is safe and effective for ureteral stricture. Dilation under direct vision using ureteroscopy has good effect for shorter ureteral stricture ; the longer and more serious ureteral stenosis should be used in conjunction with ureteroscope holmium laser incision. Placing double J tube can offer chronic expansion and better result. 　　【Key words】 Ureteral stricture;Ureteroscopy;Holmium laser 　　输尿管狭窄在临床中并不少见，尤其是输尿管镜手术的广泛开展以后，最常见原因为输尿管镜术后瘢痕形成，其它还包括炎症、先天性因素等，可造成狭窄段近端尿路梗阻，导致肾积水并发结石、感染等，后期可对肾功能造成严重损害。传统开放手术创伤大，术后并发症多。随着腔内技术的发展，输尿管镜下钬激光内切开术治疗输尿管狭窄具有创伤小、安全有效、术后并发症少等优点，在临床得到广泛应用[1]。从2013年1月至2016 年1月期间，我们应用输尿管镜下钬激光内切开术治疗 153 例输尿管狭窄，