输尿管镜手术治疗输尿管狭窄并结石的临床分析

The Treatment of Ureterscopy for Ureteral Stricture Complicated by Calculi

目的探讨应用输尿管镜技术治疗输尿管狭窄并结石的方法及效果。方法对62例患者分别采用输尿管硬性扩张、输尿管扩张导管及筋膜扩张器扩张、输尿管气囊扩张及输尿管下电切开等方法扩张输尿管狭窄部后行气压弹道碎石,术后放置双J管4～8周。结果62例患者除2例扩张不成功,其余均能顺利扩张并行气压弹道碎石治疗成功,其中有4例上段结石冲入肾内改行ESWL后结石顺利排出,综合疗效为90%。术中输尿管穿孔3例,2例单纯放置双J管,1例行开放修补,术后均无尿外渗。所有病例随访3～12个月,未见狭窄及结石复发。结论应用输尿管镜治疗输尿管狭窄并结石具有创伤小、效果好、恢复快等优点。

Objective To detect the treatment method and effectiveness for rueteral stuicture by ureterscopy. Methods 62 cases were underwent rigid ureter dilation, ureter duct or fascia dilator dilation, ureter balloon dilation or incision under ureterscope, followed by pneumatic impactor lithotripsy and laid up double pigtail for 4-8 weeks, Result 60 patients were successfully underwent ureterscopy and pneumatic impactor lithotripsy, among those 4 cases of upper ureter lithiasis escaped to renal pelvic and followed by ESWL. Only 2 patients were failure to dilation, The curative effect was 90 percent. Conclusion The treatment of ureterscopy for ureteral stricture complicated by calculi has characteristic of minimal injury, effectiveness and quick recovery.