硬性输尿管镜进出镜困难原因分析及对策  

Analysis and strategies of difficult accesses with rigid transurethral ureteroscopy

作　　者：刘元丰[1] 孙丹宁[1] 颜加强[1] 孙道东[1] 蒙明森[1] 封建立[1] 

机构地区：[1]重庆解放军第324医院泌尿肾病中心,400020

出　　处：《实用医学杂志》2012年第12期2034-2036,共3页The Journal of Practical Medicine

摘　　要：目的:探讨输尿管镜术进出镜困难的原因及对策。方法:分析本院自2007年3月至2011年7月收治的1270例输尿管镜手术患者资料。结果:145例出现进镜困难,92例采用技巧性的旋转进镜成功,17例行输尿管导管扩张或钬激光行内切开后顺利进镜,33例留置双J管、二期处理结石,3例改行开放手术。12例出现出镜困难,8例采用松开或回退取石钳、旋转镜体后顺利出镜,4例改行开放手术。结论:提高操作技巧可有效减轻输尿管进出镜困难,及时"放弃"也许是避免输尿管严重损伤的关键。Objective To analyze the reasons of difficult accesses by manipulating rigid transurethral ureteroseopy and to find out the corresponding solving methods. Methods 1 270 cases treated under transurethral ureteroscopy were evaluated from March 2007 to July 2011. Results The difficuties in the ureteroscopy insertion occurred in 145 cases, 92 cases can he achieved successfully by rotating the ureteroscopy with skill. 17 cases were done by ureteral dilatation or Holmium： YAG laser endoureteromy, 33 cases were treated by indwelling double J tube, 3 cases were converted to open surgery. The difficuties in the ureteroscopy exsertion occurred in 12 cases, 8 cases were successful for pulling out ureteroseopy, 4 cases were converted to open surgery. Conclusion Improving operational techniques can overcome the difficult accesses with rigid transurethral ureteroscopy ,and sometimes ＂abandoning＂ maybe is the key point to avoid severe ureter injuries.

关 键 词：输尿管疾病 输尿管镜 治疗 

分 类 号：R699[医药卫生—泌尿科学]