经皮顺行球囊扩张治疗输尿管-肠吻合口狭窄

Anterograde Percutaneous Ballon Dilation for Ureterointestinal Strictures Following Urinary Diversion

目的：评价经皮肾穿刺顺行球囊扩张治疗尿流改道术或原位膀胱术后输尿管-肠吻合口狭窄治疗效果。方法：对15例尿流改道术或原位膀胱术后患者，共25处输尿管-肠吻合口狭窄，采用经皮肾穿刺顺行球囊扩张，并置入输尿管支架管6周进行引流治疗。结果：本组15例中，2例双侧和1例单侧狭窄患者因导丝不能通过狭窄处，扩张失败。其余8例双侧狭窄、4例单侧狭窄患者均成功完成扩张，其中9例拔除支架管后症状好转，血肌酐下降及肾积水保持稳定，随访时间3～29个月（平均13个月），有效率60％；另3例拔除支架管后1～3个月，血肌酐进行性上升，予以再次留置输尿管内支架管并定期更换。结论：经皮肾穿刺顺行球囊扩张治疗输尿管-肠吻合口狭窄，创伤小，操作简单，可替代开放手术作为首选治疗方案。

Objective：To evaluate the efficacy of anterograde percutaneous ballon dilation for ureterointestinal strictures following urinary diversion. Methods： 15 patients with 25 benign ureterointestinal strictures were treated by anterograde percutaneous ballon dilation and stents were implanted for 6 weeks. Results： In 3 patiants the stricture could not be passed with a guide wire, precluding percutaneous treatment. Restenosis were seen in 3 patiants 1-3 months following the procedure. It succeeded in 9 patients with that the clinical symptoms were relieved and no stenosis developed so far （followed up for 3-29 months）. All success rate was 60%. Conclusions： anterograde percutaneous ballon dilation for ureterointestinal strictures is of simple and less invasion and can be as the primary procedure.