微创医学

目的探讨输尿管镜多导管扩张法治疗重度输尿管狭窄的临床疗效。方法对45例重度输尿管狭窄患者采用输尿管硬镜多导管扩张法治疗,术后留置1根6F～7F双J支架管,1～3个月后拔管。拔管后3～12个月进行超声、静脉肾盂造影检查。结果 41例手术成功,4例手术失败改开放手术。术后均有不同程度血尿,1例术后发生感染,经抗感染治疗治愈,术后1～3个月拔除双J管。38例获得随访,平均随访12个月,有效32例(84.2%),好转4例(10.5%),无效2例(5.2%)。结论输尿管镜多导管扩张法治疗重度输尿管狭窄是一种安全、有效的微创手术方法。

Objective To evaluate the efficacy of ureteroscopy and multiple catheter dilatation in the treatment of severe ureteral stricture． Methods 45 patients with severe ureterostenosis received ureteroscopy and multiple catheter dilatation． One double pigtail stent ( F6 － F7) was placed in the ureter after the operation and left indwelling for 1 to 3 months． Ultrasonography and excretion urography were performed 3 to 12 months after extubation． Results Of the 45 cases，41 cases were successful，4 cases were unsuccessful and switched to open surgery． All cases had hemorrhage in different degrees． 1 case were infected but cured after anti-inflammation． The ureteral stents were removed after 1 － 3 months． 38 cases were followed up for 12 months on average． 32 ( 84． 2%) cases were cured，4 ( 10． 5%) improved，and 2 ( 5． 2%) unresponsive．Conclusion Ureteroscopy and multiple catheter dilatation are safe，effective and minimally invasive to treat severe ureteral stricture．

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