输尿管镜手术医源性损伤原因分析和防治对策  

Causal analysis and preventive treatment of iatrogenic injury made by ureteroscopy

作　　者：李擎东[1] 胡平成[1] 樊皓明[1] 高智勇[1] 

机构地区：[1]长沙湖南省人民医院泌尿外科,湖南410005

出　　处：《国际泌尿系统杂志》2011年第5期580-582,共3页International Journal of Urology and Nephrology

摘　　要：目的分析输尿管镜手术造成医源性损伤的主要原因并制定相应的防治对策。方法回顾性研究2004年至2009年间的2683例输尿管镜诊疗的病例，其中造成医源性损伤共36例，分析其发生原因，根据原因来探究防治对策。结果36例医源性损伤的病例中，27例输尿管穿孔留置DJ管4～8周后痊愈。3例输尿管断离及时行开放手术吻合成功。4例输尿管大出血，药物及手术治疗后出血停止。2例输尿管闭锁导致患肾无功能，最后行肾脏切除。结论输尿管镜是泌尿外科常用的微创技术，如操作不当可导致严重并发症，防止并发症的蓑键就是掌握好适应征和提高输尿管操作技巧。Objectives To analyze the causes of iatrogenic injury made by uretemscopy and decide the corresponding preventive treatment. Methods To retrospectively study 2683 eases which have ureteroseopy. 36 cases occur iatrogenic injury, to analyze the major eanses, then find out the countermeasure. Results Among of 36 cases with occur iatmgenie injury, 27 cases ureteral perforation are recovered completely retemting D - J tube in 4 - 8 weeks. 3 eases ureteral iridodialysis are cured with uretemureterostomy, 4 cases ureteral hemorrhage bleeding stop by means of hemostatic and operation. 2 eases ureteral atresia leading to no functional kidney, finally take nephre - ctomy. Conclusions Ureteroscopy is a kind of urological minimally invasive surgery that is frequently - used. Serious complications will happen easily in case of misoperation. The key of preventive treatment is well mastering indica- tions and enhancing the skill of urotemscopy.

关 键 词：输尿管镜检 

分 类 号：R699[医药卫生—泌尿科学]