摘要
目的总结腔内泌尿外科技术治疗输尿管狭窄的临床疗效。方法回顾性分析237例应用腔内泌尿外科技术治疗输尿管狭窄患者资料。男128例,女109例。年龄8～56岁,平均37岁。其中输尿管狭窄182例,闭锁55例。狭窄段长度<1．5 cm者179例,1．5～4．0 cm者22例, >4．0 cm者36例。狭窄位于肾盂输尿管连接部者85例,输尿管上段者48例、中段者18例、下段者51例,2处或以上狭窄段者35例。结果194例(81．9％)通过内窥镜找到正确引导方向,采用输尿管狭窄电刀内切开术84例,激光内切开术32例,输尿管镜镜体扩张术16例,导管扩张术27例,球囊扩张术35例。术后1年获随访181例,134例(74．0％)一次手术治愈,47例(26．0％)出现狭窄复发需重复扩张、内切开术或金属网状支架植入术。结论腔内泌尿外科技术可有效治疗输尿管狭窄,主要以狭窄段长度<1．5 cm、程度为轻中度、性质为损伤性、患肾功能良好(>总肾功能的25％)的病例效果较好。
Objective To evaluate the endourological techniques in the treatment of ureteral stricture. Methods The data of 237 cases （ 128 males and 109 females;mean age,37 years;age range ,8 -56 years） of ureteral stricture treated by endourological techniques from October 1995 to March 2004 were reviewed. Of them, 182 cases had ureteral stricture and 55 had ureteral atresia. There were 179 cases with the length of ureteral stricture 〈 1.5 cm ,22 cases with the length between 1.5 and 4.0 cm and 36 cases with the length 〉 4.0 cm. The stricture was at the ureteropelvic junction （UPJ） level in 85 cases,in the upper ureter in 48,in the middle ureter in 18,in the lower ureter in 51 ,and at multiple levels in 35. Results Among 237 cases, the right direction was found by endoscope in 194 cases （81. 9% ）. Of them ,84 cases were treated by electrocautery endoureterotomy ,32 cases by laser endoureterotomy, 16 cases by dilation on ureteroscopy under direct vision,27 cases by catheter dilation,and 35 cases by balloon dilation. Postoperatively, 181 cases were followed up for a year. Of them, 134 cases （74.0%） were cured after a single session of dilation or endoureterotomy ,and 47 recurrent cases （26.0%） needed further therapy （ including repeated dilation or endoureterotomy and memory stent implantation）. Conclusions Endourological techniques are effective in the treatment of ureteral strictures, mainly for selected cases. The selection criteria include the length （ 〈 1.5 cm） , the severity （mild or moderate） ,the characteristic （traumatic） of the stricture and the renal function （ 〉25% of the total function）.
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2006年第9期608-611,共4页
Chinese Journal of Urology
关键词
输尿管梗阻
支架
内窥镜术
Ureteral obstruction
Stents
Endoscopy
