输尿管镜治疗输尿管结石失败的原因和处理对策

Reasons and Countermeasures of Failure Ureteroscopy Operation for Ureteral Calculi

目的 探讨输尿管镜术 (URSL)失败的原因和相应的处理对策。方法 回顾性总结了 74侧输尿管镜术失败的临床资料 ,分析其失败的原因和相应的处理方法。结果 URSL失败的原因包括不能接近结石 46侧 ,处理结石困难 12侧 ,造成输尿管损伤15侧。失败后改行开放手术 44侧 ,治疗成功率 10 0 % ;改行ESWL 3 4侧 ,治疗成功率为 85 3 % ;仅 1例死亡。结论 输尿管镜术失败的原因包括不能接近结石、结石处理困难和输尿管损伤等。疗效与器械因素、术者因素和患者因素均有关。精良的设备、熟练的技巧和正确地选择病例是手术成功的关键。操作遇到困难应采取正确、及时的对策。失败后应根据情况改用ESWL或开放手术治疗。

Purpose To find the reasons and explore the appropriate countermeasures for failure ureteroscopy operation.Methods The clinical data of 74 cases with failure ureteroscopy operation for ureteral calculi were analysed respectively.Results The failure reasons including the difficult of ureteroscopy insert (46 lateral),difficult of calculi disposal (12 lateral) and ureteral injure (15 lateral).ESWL(34 sides) and open surgery(44 sides) were remedial measures after failure ureteroscopy and the success rates we...