经尿道输尿管镜球囊扩张治疗输尿管狭窄的疗效及预后相关分析  

Analysis of the efficacy and prognosis of transurethral ureteroscopic balloon dilatation for ureteral stricture

作　　者：胡安定 钱挺照 胡赛峰 胡春 HU Anding;QIAN Tingzhao;HU Saifeng;HU Chun(Department of Urology,Yongkang Hospital of Traditional Chinese Medicine in Zhejiang Province,Yongkang 321300,China)

机构地区：[1]浙江省永康市中医院泌尿外科,永康321300

出　　处：《浙江医学教育》2025年第2期119-123,共5页Zhejiang Medical Education

摘　　要：目的探讨经尿道输尿管镜球囊扩张治疗输尿管狭窄(ureteral stricture,US)的疗效及预后相关分析。方法选择2019年1月—2022年1月浙江省永康市中医院诊治的60例US患者为研究对象,按照随机数字表达将其分为试验组和对照组,每组30例患者。试验组患者采用经尿道输尿管镜球囊扩张术治疗,对照组患者采用腹腔镜下输尿管成形术治疗。术后随访6个月,比较两组患者的疗效,并根据随访结果将患者分为预后良好组和预后不良组。采用单因素分析、多因素Logistic回归分析US患者预后的影响因素。结果试验组患者总有效率(90.00%)优于对照组患者(66.67%),其差异具有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,病程>1年、多发狭窄、狭窄长度>1 cm、选择腹腔镜下输尿管成形术治疗等为US患者预后不良的独立危险因素(P<0.05)。结论经尿道输尿管镜球囊扩张术为治疗US的有效方式之一,病程、狭窄数量、狭窄长度、手术方式等与患者预后密切相关。临床治疗时需要综合考虑以上因素,合理选择治疗方式,改善患者预后效果。Objective To investigate the efficacy and prognosis of transurethral ureteroscopic balloon dilation in the treatment of ureteral stricture(US).Methods A total of 60 US patients admitted in Yongkang Hospital of Traditional Chinese Medicine in Zhejiang Province from January 2019 to January 2022 were selected as the study objects,and were divided into experimental group(30 cases)and control group(30 cases)according to the random number table method.The experimental group was treated with transurethral ureteroscopic balloon dilatation,and the control group was treated with laparoscopic ureteroplasty.After 6 months of follow-up,the efficacy of the two groups was compared,and the patients were divided into good prognosis group and poor prognosis group according to the follow-up results.Univariate analysis and multivariate Logistic regression were used to analyze the influencing factors of prognosis in US patients.Results The total effective rate of experimental group(90.00%)was higher than that of control group(66.67%)(P<0.05).Multivariate Logistic regression analysis showed that disease duration>1 year,multiple strictures,stenosis length>1 cm,and laparoscopic ureteroplasty were independent risk factors for poor prognosis in US patients(P<0.05).Conclusions Transurethral ureteroscopic balloon dilatation is one of the effective methods for the treatment of US.The course of disease,the number of strictures,the length of strictures,and the operation method are closely related to the prognosis of patients.The above factors should be considered in clinical treatment,and the treatment method should be rationally selected to improve the prognosis of patients.

关 键 词：经尿道输尿管镜球囊扩张 输尿管狭窄 疗效 预后 

分 类 号：R684[医药卫生—骨科学]