摘要
目的总结硬性输尿管镜术中入镜困难的处理经验。方法1995年1月-2004年11月，应用F8/9.8输尿管硬镜逆行治疗640例输尿管结石，72例入镜困难，通过控制液压灌注泵压力、改变病人体位、扩张输尿管、肾穿刺造瘘等方法处理。结果成功入镜54例，18例改开放手术。术中并发症16例，其中10例黏膜部分撕裂，6例输尿管穿孔（放置支架管引流后治愈）。56例随访13—36个月，平均16个月，静脉肾盂造影显示输尿管通畅。结论熟悉输尿管的解剖与病理生理特点，入镜成功的关键在于手术者的操作技巧与经验。
Objective To summarize the management experience for difficult access during rigid transurethral ureteroscopy. Methods Rigid transurethral ureteroscopy was conducted in 640 patients with ureteral stones from January 1995 to November 2004, Difficult ureteroscope access was encountered in 72 patients and overcame by adjusting the pressure of hydraulic irrigation, changing the position of patient, dilating the ureter, or performing the percutaneous nephrostomy. Results Of the 72 patients with difficult retrograde access, successful ureteroscopy was achieved in 54 patients and conversions to open ureterolithotomy were required in 18 patients. Intraoperative complications included partial mucosal laceration in 10 patients and ureteral perforation in 6 patients, Follow-up examinations with intravenous pyelography for 13 - 36 months （ mean, 16 months） in 56 patients revealed patent ureter. Conclusions The key to successful retrograde access of rigid ureteroscope lies in the acquaintance with normal and pathologic anatomy and physiology of the ureter and urologist＇ s operative skills and experience.
出处
《中国微创外科杂志》
CSCD
2006年第8期604-605,共2页
Chinese Journal of Minimally Invasive Surgery
