输尿管镜术治疗急性上尿路梗阻

Treatment on Acute Upper Urinary Tract Obstruction with Ureteroscopy

目的 评估输尿管镜术治疗急性上尿路梗阻的疗效。方法 1998- 0 5～ 2 0 0 3- 12 ,共采用输尿管硬镜急诊治疗 6 9例输尿管结石引起的上尿路梗阻。结果 所有病例手术全部成功 ,均放置好输尿管内双J管 ,术中无输尿管穿孔和黏膜撕脱的并发症发生。 6 6例患者术后马上恢复尿量 ,1例患者术后 4d死于败血症、呼吸衰竭。结论 输尿管镜处理急性上尿路梗阻简单、安全、有效 ,但对于已合并感染的病例 ,感染性休克和败血症是术后最危险的并发症 。

Purposes To evaluate the effect of the ureterscope in treating the acute upper urinary tract obstruction.Method Between May,1998 to Dec,2003, 69 cases of upper urinary tract obstruction caused by ureteral stones were treated by ureterscope.Results All procedures were successful, and with double-J stent placed appropriately. There was no ureter perforation and avulsion happened and Urine volume resumed soon after operation in 66 cases .But 1 patient died of septemia and respiratory failure 4 -days postoperation .Conclusion Using ureterscopy in treating acute upper tract ob struction was easy ,safe and effective .But to the patients with urinary infection ,infective shock and septemia was the most dangerous complication ,and should be prevented .