输尿管梗阻性疾病腔内诊疗研究

Dianosis and treament of ureteral obstraction with endoscopy

目的探讨腔内镜对输尿管梗阻性疾病的诊疗价值。方法对2002年1月～2005年1月期间收治46例输尿管息肉、肿瘤、狭窄及囊肿等梗阻性疾病通过腔内镜检查明确诊断,部分病例需要内镜下活组织检查,经病理确诊;采用不同腔内镜,或其中两镜联用进行治疗。结果46例输尿管梗阻中输尿管息肉11例;输尿管肿瘤9例;输尿管囊肿5例;输尿管狭窄21例。所有病例均行腔内镜治疗(3例依靠腔内镜明确诊断同期给予治疗)。治疗成功率为94.3%,无输尿管穿孔等并发症。结论腔内镜有助于明确输尿管占位良恶性,并对早期输尿管肿瘤确定诊断;多数输尿管梗阻性疾病可以同期完成诊断和治疗,缩短诊疗周期;微创、高效使治疗可重复进行。

[Objective] To evaluate the diagnosis and treatment value of endoscopy in ureteral obstraction. [Methods] 46 cases of ureteral polypi, tumor, stenosis and ureterocele from January 2002 to January 2005 were confirmed by endoscopy, and some cases received endoseopyic biopsy and were confirmed by pathology; All cases were treated by enoscopy or combination of two methods according to different disease. [Results] There were 5 cases with ureteroeele and 21 cases with ureteral stenosis, and treatment of endoscopy was performed （3 cases were confirmed by endoscopy and received treatment at the same time）. The successful rate was 94.3%, and no complications occurred such as ureterperforation, etc. [Conclusions] Endoscopy is helpful in identifying the pathologic features of ureteral space occupying lesion, and confirming the diagnosis of ureteral tumor. Endoscopy is helpful in diagnosis and treatment at the same time for most of the ureteral obstructive disease and can shorten diagnosis and treatment period,it can be used repeatedly because it is shghdy traumatic and highly effective, and make it possible to apply successive treatment.