输尿管镜下2μm激光治疗复杂性尿道狭窄及闭锁  

Complexity urethral stricture andatresia treated by 2μm laser under ureteroscopes

作　　者：刘德云 刘显中 周健 蔡容 吴媛媛 

机构地区：[1]武警重庆总队医院泌尿外科,重庆400061

出　　处：《武警医学院学报》2010年第6期459-460,共2页Acta Academiae Medicinae CPAPF

摘　　要：【目的】探讨应用输尿管镜下2μm激光治疗复杂性尿道狭窄或闭锁临床操作方法及其治疗效果。【方法】椎管内麻醉下8/9.8F输尿管镜直视下进镜至尿道狭窄部,并用输尿管导管(或斑马导丝)引导,或利用耻骨上膀胱穿刺造瘘,冷光源引导,闭锁较长者则经耻骨上穿刺造瘘口用尿道探子与输尿管镜会师定位,而后通过输尿管镜置入2μm激光(Revolix laser)光纤,汽化切除狭窄部癍痕后留置尿管。【结果】术中所有病例均能留置18-20F尿管引流尿液,术后留置尿管6周。拨除尿管后,11例拔管后排尿通畅,2例排尿不畅,行1～3次尿道扩张排尿正常。随访半年无复发。【结论】输尿管镜直视下利用2μm激光(Revolixlaser)汽化切除尿道狭窄或闭锁部纤维癍痕并置管,损伤小,恢复快,疗效佳。【Objective】To study the operation method and treatment effectiveness that complexity urethral stricture and atresia（CUSA） treated by 2μm laser use by ureteroscopes.【Methods】 To place the ureteroscopes on into the location of urethral stricture under lumbar anesthesia on 8/9.8F,then coducted by ureteral catheter（or Zebra guide wire）,or stomaed by suprapubic puncture coducted by cold light source,the case that had atresiaed for long-time combined located by urethral probe and ureteroscopes with puncture for stoma through pubic bone,then placed 2μm Revolix laser optical fiber by ureteroscopes.Cutted the detaining ureter in the stenosis by vaporization.【Results】All of the cases could detain 18-20F ureter for drainning urine intraoperatively and for 6 weeks in postoperation.After remove the ureter,11 cases were urinated unobstructed,2 cases obstructed and to normal after urethral sounding with 1-3 times.No recurrence was occurred in follow up for half a year.【Conclusions】 This method that treat urethral stricture and atresia by 2μm Revolix laser to cutted the detainning ureter in the stenosis by vaporization under ureterscopes was minor injuries recovery time and better curative effect.

关 键 词：复杂性尿道狭窄 尿道闭锁 输尿管镜 激光 

分 类 号：R699.6[医药卫生—泌尿科学]