输尿管镜手术入镜困难的原因分析及处理技巧探讨  

Difficulties and strategies in ureteroscopic insertion

作　　者：潘家强 覃展偶[2] 龚明军 

机构地区：[1]广西临桂县人民医院泌尿外科,541100 [2]桂林医学院附属医院泌尿外科

出　　处：《临床外科杂志》2011年第10期691-693,共3页Journal of Clinical Surgery

摘　　要：目的探讨输尿管镜手术时入镜困难的原因与处理技巧。方法648例患者行输尿管镜手术，对其中43例发生入镜困难的患者进行回顾性分析，根据不同病因采取相应的入镜方法处理。结果4例采用变换进镜角度、技巧性旋转入镜取得成功，34例采用调整体位、利用各种辅件等处理使输尿管扩张而获得入镜成功，1例入镜失败后予插管后行ESWL，4例入镜失败中转开放手术。结论输尿管扭曲、狭窄是输尿管镜入镜困难最主要的原因，熟悉输尿管的解剖与镜下立体空间结构，根据不同病因采取相应的入镜处理技巧是取得成功的关键。Objective To study the reasons of difficult ureteroscopic insertion, and discuss their solutions. Methods From April 2005 to 2010 December in a total of 648 patients subjected to ureteroscopie surgery,43 patients had difficult insertion due to different causes and adopted, corresponding treatments. Their clinical data were retrospectively analyzed. Results Four cases were solved by adjusting the insertion angle and skillfully rotating,the ureteroscope; 34 cases were solved by adjusting postures and using various auxiliaries to make ureter expanded; 1 case failed and received intubation with ESWL; 4 cases failed and received open surgery. Conclusion Distortion and stricture of ureters are the main reasons of difficult ureteroscopic insertion. Based on familiarization with ureteral anatomy and endoscopic spatial structure, choosing appropriate insertion methods according to different causes is the key to success.

关 键 词：输尿管疾病 输尿管镜技术 入镜困难 

分 类 号：R69[医药卫生—泌尿科学]