输尿管镜联合电切镜治疗输尿管末端结石疗效分析  

Ureteral meatotomy with ureteroscope in treatment of distal ureteric calculi

作　　者：楼水鑫[1] 丁青[1] 任黎刚[1] 肖家全[1] 邹强[1] 祁小龙[1] 章越龙[1] 

机构地区：[1]浙江省人民医院泌尿外科,杭州310014

出　　处：《浙江医学》2011年第6期833-835,共3页Zhejiang Medical Journal

摘　　要：目的 通过与金属橄榄头扩张器输尿管口扩张术比较,评价输尿管镜联合电切镜治疗输尿管末端结石的疗效.方法 经尿道途径采用电切镜对输尿管壁段黏膜切开（55例,电切组）或金属橄榄头扩张器输尿管口进行扩张（32例,扩张组）后,再行输尿管镜碎石取石术.对两组手术时间、术后住院时间、并发症和随访情况等进行比较.结果 两组患者均一次手术解除梗阻,电切组手术时间35～58（45±3.7）min,术后住院时间2～5（3.1±0.2）d;扩张组手术时间47～67（55±5.6）min,术后住院时间2～5（3.3±0.3）d.电切组手术时间明显短于扩张组（P＜0.05）,术后住院时间无明显差异（P ＞0.05）.79例患者随访1～39个月（平均15个月）,无一例发生膀胱输尿管反流及输尿管口狭窄.结论 输尿管镜联合电切镜操作精确、简单易行、创伤小、效果确切,值得临床借鉴.Objective To compare ureteral meatotomy with ureteroscope to ureteral metal dilator in treatment of obstruction of distal ureteric calculi. Methods Ureteral meatotomy was undertaken with resectoscope to release the obstruction of the distal ureter and the treatment of calculi with ureteroscope was followed in 55 cases. Ureteral dilatation was undertaken in other 32 cases. The operation time, discharge time, postoperative complications and clinical results were compared between two groups. Results The obstruction was released and calculi were extracted in all patients by single procedure. The surgical time of ureteral meatotomy group was 35 - 58（ 45 ± 3.7 ）min ,the postoperative hospital day was 2 - 5（ 3.1 ± 0.2 ）d. Those for ureteral dilation group were 47 - 67 （55± 5.6 ）rain and 2 - 5（ 3.3 ± 0.3 ）d, respectively. Data correlation indicate the former group was superiority （P 〈 0.05 ）. Seventy nine patients were followed up for 1-39 months and no regurgitation or stenosis of the ureter recurred. Conclusion Ureteral meatotomy is safe and effective in treatment of distal ureteric calculi.

关 键 词：输尿管镜 电切镜 输尿管口切开术 输尿管末端结石 

分 类 号：R692.4[医药卫生—泌尿科学]