摘要
目的探讨输尿管镜下结合铥激光技术尿道内切开治疗尿道狭窄及闭锁中的效果。方法本院于2005年1月－2010年12月期间对65例尿道狭窄或闭锁的患者在输尿管镜下行铥激光尿道狭窄处内切开术，切除局部纤维瘢痕组织，修整尿道黏膜面，使管腔光滑；尿道闭锁者先行4号尿道探子经耻骨上膀胱造瘘121，沿膀胱前壁滑入尿道内口，然后经尿道置入输尿管镜与尿道探子对接。找到尿道后，将4号输尿管导管经输尿管镜插入膀胱内，输尿管镜随后穿越狭窄段进入膀胱内。铥激光放射状切开尿道狭窄环，并切除、修整尿道内面瘢痕组织，使管腔光滑，直至顺利通过20号尿道探子。结果所有患者手术过程均顺利，55例一次手术治愈，4例经多次尿道扩张后治愈，4例在术后3个月至1年再次尿道狭窄，行铥激光内切开后治愈，2例3次铥激光内切开手术后治愈。术后前尿道瘘1例，持续导尿后自愈。术后3个月、6个月平均最大尿流率分别为（22．3±3．3）ml／s，（20．1±2．5）ml／s。结论输尿管镜结合铥激光行尿道内切开加瘢痕切除术是治疗尿道狭窄及闭锁安全、创伤小、并发症少，疗效显著，有效的治疗方法。
Objectives To investigate the effects of ureteroscope with thulium laser urethrotomy in the treatment of urethral stricture and occlusion. Methods During Jan 2005 - Dec 2010, thulium laser imeision of urethral stricture under ureteroscopy for 65 patients with urethral stricture or atresia, localized fibrous scar tissue removed, trimmed urethral mucosa, so that smooth lumen ; urethral atresia urethral probe first 4 suprapubic stoma, slip into the urethra along the anterior bladder mouth, and then transurethral ureteroscopy and urethral probe into dock. Find the urethra, will be No. 4 ureteral catheter into the bladder by ureteroscopy, ureterescopy followed through the stricture into the bladder. Thulium laser radial incision of urethral stricture ring, and excision, repair scar tissue in- side the urethra, the lumen is smooth, until the probe passed the urethra 20. Results All patients were success- fully during surgery, an operation 55 cases were cured, 4 patients were cured after repeated urethral dilation, 4 patients after 3 months to 1 year re - stricture, thulium laser incision line were cured, 2 Example 3 times thulium laser incision healing after surgery. 1 case of anterior urethral fistula after surgery, continuing self - healing after catheterization. After 3 months, 6 months, the average maximum flow rate was （22.3 ± 3.3 ） ml / s, （20.1 ± 2.5） ml / s. Conclusions Ureteroscopy with thulium laser urethrotomy plus line scar excision is the treatment of urethral stricture and atresia safety, trauma, fewer complications, a significant effect, effective treatment.
出处
《国际泌尿系统杂志》
2012年第1期50-52,共3页
International Journal of Urology and Nephrology
关键词
尿道狭窄
输尿管镜
激光
Urethral Stricture
Ureteroscopy
Laser
