输尿管镜、斑马导丝、筋膜扩张器在医源性尿道损伤狭窄治疗中的应用  

Ureteroscope combined with zebra urological guidewire and fascia dilator in treatment of iatrogenic urethral stricture after injury

作　　者：何建光[1] 程伟[1] 范郁会[1] 汪珂[1] 周明[1] 张志辉[1] 艾力[1] 

机构地区：[1]西安高新医院泌尿外科,西安710075

出　　处：《临床泌尿外科杂志》2017年第7期549-550,553,共3页Journal of Clinical Urology

摘　　要：目的:探讨输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄的方法和疗效。方法:回顾性分析输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄21例患者的临床资料。结果:21例患者采用该法成功施行尿道扩张,其后留置尿管,历经3~12次不等的尿道扩张,均未发生尿路感染、附睾炎、尿道大量出血、尿道穿破或假道形成等严重并发症。21例均获得随访,术后随访2~16个月,15例排尿通畅,尿线粗而有力,另6例因尿道瘢痕重、狭窄段较长需长期行尿道扩张,其中5例加行冷刀内切开、瘢痕电切术,1例行尿道成形术后治愈。结论:输尿管镜直视下置入斑马导丝,筋膜扩张器在斑马导丝引导下治疗医源性尿道损伤狭窄操作简单,成功率高,并发症少,值得临床推广。Objective：To investigate the effect and method of iatrogenic urethral stricture after injury treated by ureteroscope combined with zebra urological guidewire and fascia dilator.Method：Clinical data of 21 patients treated by ureteroscope combined with zebra urological guidewire and fascia dilator were analyzed retrospectively.Result：Twenty-one patients were successfully cured after 3-12 times of urethral sounding and then catheter indwelling,without serious complications such as urinary infection,bleeding,bladder perforation,false passage or epididymitis.All 21 patients were followed up by clinic reexamination for 2-16 months.Fifteen cases pee easily and smoothly,and the urinary streams were thickness and powerful.Another six cases needed frequent and longterm expansion due to serious urethral scar and stricture,in which five cases underwent treatment of cold knife incision and scar electroresection,one case underwent urethroplasty.Conclusion：It is easy to cure iatrogenic urethral stricture after injury by ureteroscope combined with zebra urological guidewire and fascia dilator with high success rate and less complications.Therefore,it deserves wide clinical application.

关 键 词：输尿管镜 斑马导丝 筋膜扩张器 

分 类 号：R695[医药卫生—泌尿科学]