输尿管镜钬激光碎石术后致输尿管狭窄闭锁的诊治体会  

Diagnosis and treatment of ureteral stricture caused by ureteroscope holmium laser lithotripsy

作　　者：申杰[1] 邹岷[1] 肖民辉[1] 章卓睿[1] 张宁南[1] 杨茂林[1] Shen Jie;Zou Min;Xiao Minhui;Zhang Zhuorui;Zhang Ningnan;Yang Maolin(Urology Surgery,the First People's Hospital of Yunnan Province 650000)

机构地区：[1]云南省第一人民医院泌尿外科,650000

出　　处：《中国社区医师》2016年第6期65-66,共2页Chinese Community Doctors

摘　　要：目的:探讨输尿管镜钬激光碎石术后致输尿管狭窄的原因和诊治方法。方法:收治输尿管镜钬激光碎石术后致输尿管狭窄闭锁患者7例,其中2例患者输尿管镜探查狭窄段为膜状,给予钝性扩张后,留置双J管半年;4例输尿管完全闭锁患者行切除吻合术治疗;1例患者输尿管狭窄段约5 mm,周围明显瘢痕化,给予钬激光切开后留置两根双J管,术后半年留置1根双J管,维持1年。结果:2例输尿管镜探查显示输尿管狭窄段为膜状的患者拔管后恢复良好。4例输尿管完全闭锁患者术后再无狭窄。1例患者给予钬激光切开后留置双J管拔出后恢复良好,再无狭窄。结论:切除吻合术为治疗输尿管镜钬激光碎石术后致输尿管完全闭锁患者的有效方法,输尿管狭窄段为膜状及狭窄长度<5 mm的患者,建议应用扩张置管治疗。Objective:To explore the diagnosis and treatment methods of ureteral stricture caused by ureteroscope holmium laserlithotripsy.Methods:7 cases with ureteral stricture caused by ureteroscope holmium laser lithotripsy were selected. In this group ofpatients,stenosis segment of 2 cases by ureteroscope were membranous,after half a year of blunt extension and indwelling double Jtube.4 patients with complete ureteral atresia were treated with resection and anastomosis.The length of the ureteral stricture of 1patient was about 5 mm;there was obvious scar around;they were treated by two double J tube indwelling after holmium laserincision;six months after operation,a double J tube was left;after a year,it was pulled out.Results:For stenosis segment of 2 cases byureteroscope were membranous,recovery after extubation was good.For complete ureteral atresia of 4 patients,after operation,therewas no stenosis.For 1 patient treated with two double J tube indwelling after holmium laser incision,after the tube pulled out,therewas no stenosis.Conclusion:Resection and anastomosis was an effective method for treatment of ureteral stricture caused byureteroscope holmium laser lithotripsy.For patients with membranous ureterostenosis and narrow length less than 5 mm,werecommend that you should use expansion catheterization for treatment.

关 键 词：输尿管镜钬激光碎石术 输尿管狭窄闭锁 原因 诊治 

分 类 号：R699.4[医药卫生—泌尿科学]