钬激光经输尿管镜内切开治疗输尿管狭窄(附45例报告)  

Treatment of ureterostenosis by holmium:YAG laser endoureterotomy(Report of 45 case)

作　　者：贾志刚[1] 许亚宏[1] 张素琼[1] 莫非[1] 赵敏[1] 

机构地区：[1]解放军第452医院泌尿外科,四川成都610021

出　　处：《四川医学》2011年第12期1907-1909,共3页Sichuan Medical Journal

摘　　要：目的探讨输尿管镜钬激光内切开术治疗输尿管狭窄的方法与疗效。方法输尿管狭窄患者45例,狭窄位于输尿管上段24例,中段8例,下段13例,输尿管狭窄长度为0.2～1.6cm。采用输尿管镜钬激光内切开狭窄段,术后留置F5～F6号双J管2根,8～12周拔除双J管,拔管后3～6个月进行超声、静脉肾盂造影检查。结果手术时间30～60min,术后无输尿管穿孔、漏尿及感染等发生。42例随访3～15个月,平均9个月。37例治愈(治愈率88%),患者肾脏积水减轻,输尿管狭窄段消失或较治疗前增宽;3例好转;2例无效,肾积水,输尿管扩张加重,仍有腰部胀痛及反复感染症状。结论输尿管镜下钬激光内切开治疗输尿管狭窄创伤小,恢复快,并发症少,效果满意。Objective To determine the method and curative effect of ureterostenosis treated by holmium：YAG laser en- doureterotomy. Methods A total of 45 patients with ureterostenosis （24 in the upper,8 in the mid,and 13 in the lower ureters） underwent holmium ： YAG laser endoureterotomy using ureteroscopy. The stricture length was 0. 2 to 1.6 cm. Postoperatively, two pigtail stents（ F5 or F6 ） were remained indwelling for 8 - 12 weeks. Ultrasonography and excretion urography were performed 3 to 6 months after extubation. Results The operative duration was 30 - 60 rain （ average 45 rain）. There was no case of perforation, leakage of urine and infection. Follow-up was available for 3 to 15 months （mean ,9months）in 42 patients, of which 37 （88%）were cured after the treatment. In the cured patients, hydronephrosis and ureterostenosis were improved. In the other 5 patients, 3 were improved after the treatment;and 2 failed （the symptoms of hydronephrosis and ureteral dilation deteriorated , and pairl in the kidney region and infection were developed）. Conclusion Holmium ： YAG laser endoureterotomy is an efficient and safe treatment for ureterostenosis with less invasion,less complications and easy recovery.

关 键 词：输尿管狭窄 钬激光 输尿管镜术 

分 类 号：R699[医药卫生—泌尿科学]