输尿管扩张球囊导管在输尿管口狭小无法进镜患者中的应用

Application of Ureteral Dilated Balloon Catheter in Patients with Ureteral Stricture

目的探索输尿管扩张球囊导管在输尿管口狭小无法进镜患者中的应用价值,并评估其疗效及安全性。方法选取医院2018年8月至2019年5月收治的156例在行输尿管镜诊治过程中发现的12例输尿管口狭小无法进镜患者,使用5°Wolf 6/7.5Fr输尿管镜,沿输尿管镜工作通道置入球囊充盈直径为4 mm的输尿管扩张球囊导管,直视下扩张输尿管口,在扩张球囊导管引导下上行输尿管镜,视术中情况酌情留置DJ管,观察进镜效果。结果12例行球囊扩张后均顺利进镜,2例术后轻度肉眼血尿,无输尿管穿孔、输尿管口丢失等并发症。10例留置DJ管2~4周,2例未留置DJ管。术后无肾绞痛发作,无腰痛等不适。术后均随访6个月以上,未发现输尿管狭窄及输尿管膀胱反流。结论输尿管口狭小致输尿管镜上行困难行球囊扩张是一种值得推荐的安全有效的方法,对输尿管口损伤小,成功率高。

Objective To explore the application value of ureteral dilated balloon catheter in patients with ureteral stricture and evaluate its efficacy and safety.Methods From August 2018 to May 2019,we found 12 of 156 patients with narrow ureteral orifice who could not enter with ureteroscope during the diagnosis and treatment.Under the 5°wolf 6/7.5 fr ureteroscope,a dilated balloon catheter with a diameter of 4 mm was placed along the working channel of ureteroscope,and the ureteral orifice was dilated under direct vision.Under the guidance of the dilated balloon catheter,the ureteroscope was ascended,and DJ tube was retained as appropriate during the operation.Results 12 cases underwent balloon dilatation,2 cases had mild hematuria,no ureteral perforation,loss of ureteral orifice and other complications.The DJ tube was left in 10 cases for 2~4 weeks,and the DJ tube was not left in 2 cases.There was no renal colic or low back pain after operation.All patients were followed up for more than 6 months,no ureteral stricture or uretero vesical reflux was found.Conclusion Balloon dilatation is a safe and effective method for difficulty in ascending ureteroscope because of the narrow ureteral orifice,which has the advantages of small injury and high success rate.