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作 者:伍信阳[1] 周兴[1] 陈志光[1] 曾格瓦[1] 何兆伟[1] 谢文琪[1]
机构地区:[1]广州医学院第二附属医院泌尿外科,510260
出 处:《岭南现代临床外科》2006年第5期369-370,374,共3页Lingnan Modern Clinics in Surgery
摘 要:目的对膀胱镜下输尿管导管逆行插管困难的病例进行总结。方法从1993年9月至2005年6月期间,应用22FrStorz膀胱镜逆行插管行逆行肾盂造影,引流或灌药共1280例。共遇到插管困难病例80例:其中输尿管口狭小10例,向内侧开口20例,壁内段狭窄20例,中上段“Z”型成角20例,息肉包裹结石10例。结果80例插管困难病例成功60例。成功率75%。20例插管失败者改行输尿管镜插或MRU(磁共振尿路水成像)。术中出现并发症20例。10例为小的穿孔。10例为粘膜撕裂出血。结论泌外医生应熟识输尿管解剖生理和病理。应对膀胱镜进行插管成功的关键在于手术者的操作技巧与经验。Objective To summerize the case of difficult access of retrograde ureteral catheter with cystoscope. Methods From September 1993 to June 2005, 22Fr Storz cystoscopic retrograde pyelography was used in 1280 cases. Among them,difficult catheterization was encountered in 80 cases, which it was included narrow ureteral orifice in 10 cases,medial orifice in 20 cases,intramural segmental stenosis in 20 cases,tortuous angulation of middle-upper segmental ureter in 20 cases and ureteral stone encapsulated by polyp in 10 cases respectively. Results Among 80 cases of difficult access of ureteral catheterization, 60 cases were successful.The successful rate was 75%. However,20 cases of failed catheterization were changed to use ureteroscopy or MRU.Intraoperative complications were found in 20 cases.Among them, 10 cases were small per-foration of ureter and 10 cases were bleeding of mucosal laceration. Conclusion The urologist should know well the anatomical physiology and pathology of ureter. The operator's technique and experience are successful keys to cystoscopic retrograde ureteral catheterization.
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