输尿管镜手术并发症分析与防治  

Clinical analysis and management of complications of ureteroscopy

作　　者：卓文利[1] 徐廷昭[1] 林文洪[1] 吴卫真[1] 杨顺良[1] 谭建明[1] 

机构地区：[1]南京军区福州总医院泌尿外科,福州350025

出　　处：《临床泌尿外科杂志》2008年第12期903-904,907,共3页Journal of Clinical Urology

摘　　要：目的:总结输尿管镜手术并发症及其防治措施。方法::对250例应用输尿管镜手术患者临床资料进行回顾性分析,统计术中、术后发生的各种并发症及其处理方法。结果:术中输尿管穿孔3例(1.20%),1例改行开放手术,2例经留置双J管保守治疗;术后肉眼血尿173例(69.2%),应用止血药物对症治疗1～2天后血尿消失;术后腰痛41例(16.4%),其中肾绞痛5例(2.0%),针对引起腰痛的不同原因进行相应处理;感染9例(3.6%),经抗感染和拔除双J管等治疗后恢复;结石残留28例(占输尿管结石患者12.4%),予保留双J管行ESWL治疗后痊愈。结论:应用输尿管镜手术成功率高,严重并发症较少见,且绝大多数行保守治疗可得到解决;熟练的手术操作是减少输尿管镜手术并发症的关键。Objective：To summarize the complications of ureteroscopy as well as following management. Methods：The medical records of 250 in patients undergoing ureteroscopy were reviewed retrospectively, The intraoperative and postoperative complications as well as their treatment were analyzed. Results： Ureteral perforation oceuned in 3 cases（1.20%）, of whom 1 underwent open operation and 2 underwent conservative treatment placed of double J tubes. Hema turia after operation was found in 173 cases（69.2%）. Hematuria mostly disappeared at 1 2 d after hemostatic drug administration. Lumbago was found in 41 cases（ 16.4 % ）, including 5 cases （2.0% ） with renal col ic. They took favorable management aiming at the cause of lumbago. Urinary tract infection occurred in 9 cases（3. 6 % ）, but dispeared after administrating antibiotics or pulling out the double J tubes. Calculous remnant was found in 28 cases（12.4%）, but they were cured by ESWL with place of double J tubes. Conclusions：High efficiency is the characteristic of the ureteroseopy, severe complications resulting from ureteroscopy are infrequent. Most of the complications can be treated with conservative management. The key to decrease ureteroseopic complications is experenced operation.

关 键 词：输尿管镜术 并发症 防治 

分 类 号：R699.4[医药卫生—泌尿科学]