经尿道输尿管球囊扩张术治疗肾盂输尿管连接部狭窄58例疗效分析  

Efficacy of ureteroscopic balloon dilation in treatment of ureteropelvic junction stricture

作　　者：曾凯[1] 闫林轩 李应龙[1] 王新敏[1] 李强[1] 倪钊[1] 王勤章[1] 李晨[1] ZENG Kai;YAN Linxuan;LI Yinglong;WANG Xinmin;LI Qiang;NI Zhao;WANG Qinzhang;LI Chen(Department of Urology,The First Affiliated Hospital of Medical College,Shihezi University,Shihezi 832008,China)

机构地区：[1]新疆石河子大学医学院第一附属医院泌尿外科,新疆石河子832008

出　　处：《现代泌尿外科杂志》2021年第5期387-390,428,共5页Journal of Modern Urology

基　　金：石河子大学成果转化与技术推广项目(No.CGZH201706);石河子大学医学院第一附属医院院级青年基金项目(No.QN201810)。

摘　　要：目的探讨经尿道输尿管镜下球囊扩张法治疗肾盂输尿管连接部狭窄的有效性及安全性。方法回顾性分析2012年2月至2017年10月行经尿道输尿管镜球囊扩张治疗的58例先天性肾盂输尿管连接部狭窄患者的临床资料,通过术后随访结果将患者进行分组,采用单因素分析法及Logistic回归分析探讨影响手术预后的危险因素。结果58例患者中37例术后2年内未发生再狭窄,有效率为63.79%(37/58)。单因素分析结果显示:狭窄段长度、狭窄程度、球囊扩张时间、留置输尿管支架管条数及带管期间有无感染5项指标在手术有效组与无效组间比较,差异均有统计学意义(P均<0.05)。Logistic回归分析发现狭窄长度、狭窄程度及留置2根输尿管支架是影响手术预后的独立危险因素(P<0.05)。结论输尿管镜直视下的球囊扩张术可作为狭窄段<1.5 cm的肾盂输尿管连接部狭窄患者的首选治疗方案,术中留置双根输尿管支架管可有效降低术后再狭窄发生率。Objective To evaluate the efficacy and safety of ureteroscopic balloon dilation in the treatment of ureteropelvic junction stricture.Methods The clinical date of 58 patients with ureteropelvic junction stricture who received ureteroscopic balloon dilation during Feb.2012 and Oct.2017 in our hospital were retrospectively collected.All patients were divided into 2 groups according to the follow-up outcomes.The factors affecting prognosis were screened with univariate analysis and Logistic regression analysis.Results During the follow-up of 2 years,37 patients(63.79%)had no recurrence,and the effective rate was 63.79%(37/58).Univariate analysis showed that length and degree of stricture,dilation time,number of stent and infection were factors influencing efficacy of dilation.Logistic regression analysis showed that length and degree of stricture,number of stent>2 were independent risk factors of prognosis.Conclusion Ureteroscopic balloon dilation is safe and effective in the treatment of ureteropelvic junction stricture less than 1.5 cm.Double ureteral stent can effectively reduce the incidence of restenosis.

关 键 词：输尿管镜 球囊扩张 肾盂输尿管连接部 预后 

分 类 号：R693.2[医药卫生—泌尿科学]