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作 者:徐久平[1] 邵明峰[1] 华和园[1] 刘明[1] 邹建安[1] 陈久发[1]
机构地区:[1]安徽中医药大学第一附属医院泌尿外科,合肥230031
出 处:《安徽医学》2013年第7期898-899,共2页Anhui Medical Journal
摘 要:目的探讨输尿管镜手术中输尿管损伤的产生原因及防治措施。方法回顾性分析2010年1月至2012年8月进行的104例输尿管镜手术,对术中发生输尿管损伤的7例患者资料进行分析、总结。结果因结石嵌顿、息肉形成、输尿管迂曲、痉挛及手术操作等因素导致术中出现输尿管损伤7例,其中输尿管开口严重撕裂1例,输尿管穿孔1例,输尿管假道形成2例,均留置输尿管支架管治愈;输尿管断裂2例,输尿管黏膜袖套样剥离1例,均改开放性手术治疗,所有患者预后良好。结论严格掌握手术指征及正确的操作方法是预防输尿管镜手术中输尿管损伤的关键,出现输尿管损伤后应及时发现并正确处理。Objective To investigate the cause, treatment and prevention of ureteral injury in rigid ureteroscopy. Methods A ret- rospective analysis was made on the clinical data of 104 cases who underwent ureteroscopy from Jan 2010 to August 2012 in our department. The 7 cases that had ureteral injuries in the operation were analysed and summarized. Results The calculus impaction, ureteral polypus, tortuosity, spasm and operation caused the ureteral injuries. One case had severe dilaceration of the ureteral orifice, 1 case had ureteral per- foration, and 2 cases had false passage, 4 cases above were treated with the placement of double J stents. Two cases had ureteral rupture and 1 case had sleeve - like avulsion of the urereral mucosa, and they were treated by open surgery. All the patients got good prognosis. Conclu- sion Mastery of indications and correct performance are key to decrease and prevent the ureteral injury of ureteroscopy. Prompt detection and proper treatment is important after the ureteral injury.
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