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目的:提高输尿管镜在泌尿系疾病的临床诊断和应用能力,拓宽其应用范围。方法:回顾性分析了应用输尿管镜诊 治346例输尿管结石等痰病的临床资料。结果:输尿管结石298例,取石成功285例,13例失败;15例输尿管内支架管上移 全部拔除;输尿管狭窄10例,经扩张后置内支架管;因血尿及输尿管和盂管交界处占位性病变(静脉肾盂造影或逆行造影显 示充盈缺损)行输尿管镜检查21例,其中单纯息肉11例,输尿管迂曲4例(全部经体位配合后成功置入内支架管)。输尿管 癌3例,未见明显病变3例。讨论:麻醉满意、上镜正确是检查治疗成功的前提,术中合理注水,保持适宜的水压,保证输尿 管充分扩张,以使视野清楚,观察准确是治疗成功的保证;同时术者操作细心、操作技术熟练是提高治疗效果的关键。置管合 理、引流充分是减少术后并发疽的重要因素。术后详细、认真的病情观察是保证顺利恢复的关键。并与体外震波碎石(ESWL) 和开放手术进行了优缺点比较,认为在大部分输尿管疾病的处理上,输尿管镜明显优于开放手术和ESWL。
Objective: To improve the ability of ureteroscopy to diagnose and apply urological diseases and to broaden its application scope. Methods: The clinical data of 346 ureteral calculi and other sputum diseases treated by ureteroscopy were retrospectively analyzed. Results: 298 cases of ureteral calculi, 285 cases of successful stone extraction, 13 cases failed; 15 cases of ureteral stent removed all up; ureteral stricture in 10 cases, after expansion of the stent; due to hematuria and ureter and the junction of the pelvis Ureteroscopy was performed in 21 patients with anorexia (intravenous pyelography or retrograde angiography), including 11 cases of polyp alone and 4 cases of ureter tortuosity (all of them were successfully inserted into the stent. 3 cases of ureteral carcinoma, no obvious lesions in 3 cases. Discussion: Anesthetic satisfaction, the right mirror is the premise of checking the success of treatment, intraoperative reasonable water, maintaining appropriate pressure to ensure the full expansion of the ureter in order to make the field of vision clear and accurate observation of the success of the treatment is guaranteed; at the same time operators carefully, operation Skilled is to improve the therapeutic effect of the key. Rational management, drainage is sufficient to reduce the incidence of postoperative gangrene and an important factor. Postoperative detailed and serious observation of the condition is to ensure the successful recovery of the key. And compared with the advantages and disadvantages of extracorporeal shock wave lithotripsy (ESWL) and open surgery, ureteroscopy is superior to open surgery and ESWL in the treatment of most ureteral diseases.