论文部分内容阅读
目的:探讨输尿管镜下逆行球囊扩张术治疗输尿管狭窄的临床疗效。方法:回顾性分析我院2010年2月~2016年2月期间逆行球囊扩张术治疗输尿管狭窄的83例临床资料,其中男45例,女38例,年龄22~70岁,平均46岁;均为输尿管单发狭窄,其中左侧37例,右侧46例;狭窄段位于肾盂-输尿管连接处3例,上段21例,中段25例,下段34例;狭窄段长度0.5~2.5cm,应用逆行球囊导管扩张狭窄段输尿管,术后留置2根F_(4.7)输尿管支架管,3个月后拔除。结果:手术时间30~60min,平均43.5min,术后住院3~6d,平均4.5d,术后无严重并发症发生。术后78例患者随访时间达6个月,其中治愈、好转和无效患者分别为42例(53.8%)、28例(35.9%)和8例(10.3%)。术后67例患者随访时间达24个月,其中治愈、好转和无效患者分别为19例(28.4%)、27例(40.3%)和21例(31.3%)。卡方检验及多分类Logistic回归分析结果均显示,患者的年龄、输尿管狭窄位置对手术预后疗效无显著影响(P>0.05);输尿管狭窄段长度、狭窄持续时间和肾盂积水程度均显著影响预后疗效(P<0.05)。结论:逆行球囊扩张术是一种安全、有效的微创治疗方式,在严格把握适应证的同时,可作为临床上治疗良性输尿管狭窄的首选方式,但其远期疗效仍有待进一步观察。
Objective: To investigate the clinical efficacy of ureteroscopic retrograde balloon dilation in the treatment of ureteral stricture. Methods: The clinical data of 83 cases of ureteral stricture treated with retrograde balloon dilatation in our hospital from February 2010 to February 2016 were retrospectively analyzed. There were 45 males and 38 females, aged 22-70 years (average 46 years) All of them were single ureter stenosis, of which 37 on the left and 46 on the right. The stenosis was located in the renal pelvis - ureter junction in 3 cases. The upper segment was in 21 cases, the middle segment in 25 cases and the lower segment in 34. The stenosis segment was 0.5-2.5 cm. The retrograde balloon catheter was used to dilate the ureter of the narrow segment. Two F_ (4.7) ureteral stent tubes were placed after operation, and were removed after 3 months. Results: The operation time was 30-60 minutes (mean 43.5 minutes). The postoperative hospital stay was 3 to 6 days (average 4.5 days). No serious complications occurred after operation. After operation, 78 patients were followed up for 6 months, of which 42 cases (53.8%), 28 cases (35.9%) and 8 cases (10.3%) were cured, improved and ineffective. Sixty-seven patients were followed up for 24 months, of which 19 (28.4%), 27 (40.3%) and 21 (31.3%) patients were cured, improved and ineffective, respectively. The results of chi-square test and multiple classification Logistic regression analysis showed that the patient’s age and location of ureteral stricture had no significant effect on the outcome of surgery (P> 0.05). The length of ureteral stenosis, duration of stenosis and hydronephrosis all significantly influenced the prognosis Efficacy (P <0.05). Conclusion: The retrograde balloon dilatation is a safe and effective minimally invasive treatment. While strictly observing the indications, it can be used as the first choice for the treatment of benign ureteral obstruction in clinic. However, its long-term efficacy remains to be further observed.