输尿管镜手术并发症分析及预防

Analysis of risk factors and prevention measures of ureteroscopy complications

目的:探讨输尿管肾镜术并发症的相关危险因素及其预防措施,以提高输尿管镜手术的安全性。方法:对118例输尿管诊断性检查及输尿管镜下输尿管结石气压弹道碎石术患者的临床资料进行回顾性分析,总结术中及术后并发症的发生与术者临床经验、操作技术技巧以及输尿管本身情况、麻醉情况等因素相关的影响。结果:输尿管损伤8例(6.7%),结石上移12例(11.7%),严重血尿10例(8.5%),术后病侧腰痛9例(7.6%),发热(>39℃)3例(2.5%)。2个月复查腹部泌尿系平片,结石清除率101例(98.1%)。结论:掌握输尿管镜操作技巧,认识输尿管镜并发症危险因素,采用正确的操作方法,有利于减少并发症的发生。

Objective：To explore the risk factors and prevention measures of ureteroscopy complications for improving the safety of ureterorenoscope. Methods：The clinical data of 118 cases with ureteroscope detecting and pneumatic lithotripsy through rigid ureteroscope were analysed retrospectively.The preoperative and postoperative complications,surgeon′s clinical experience,operative techniques and skills and the condition of ureter and anesthesia were studied. Results：The complications included ureteral injury（8 cases,6.7%）,stone upper migration（12 cases,11.7%）,haematuria（10 cases,8.5%）,lumbago（9 cases,7.6%） and fever（39 ℃）（3 cases,2.5%）.The X-ray of abdominal urinary tract was detected 2 months after operation,and the rates of stone clearance were 98.1%（101 cases）. Conclusions：The surgeons′ skills,their awareness for the risk factors of ureterorenoscope and correct operation methods can effectively prevent the occurrence of clinical complications.