目的:探讨输尿管镜技术在泌尿外科疾病诊治中的临床应用价值。方法: 2002年9月至2008年9月应用经尿道输尿管镜技术诊断和治疗泌尿系疾病患者1333例。其中行输尿管镜治疗者1200例, 包括输尿管结石1010例,其中上段结石146例、中段344例、下段520例;输尿管狭窄18例;医源性双J管滞留38例;男性尿道狭窄38例;膀胱尿道结石41例;肾盂结石8例;输尿管阴道漏5例;小儿逆行输尿管插管20例;内支架管置入22例。其中用于诊断的患者133例。结果:治疗1010例输尿管结石,成功865例,成功率为85.6%,其中治疗输尿管上、中、下段结石的成功率分别为68.5%、81.7%及93.1%;输尿管狭窄、尿道狭窄、膀胱尿道结石、输尿管阴道漏及小儿逆行输尿管插管均疗效满意。用于诊断的133例患者中,发现肿瘤4例,阴性结石48例,息肉8例,输尿管结核9例,输尿管狭窄30例,无阳性发现34例。手术失败24例。发生严重手术并发症37例,其中死亡1例,感染性休克2例,黏膜撕脱4例,穿孔15例、假道12例,严重出血3例。结论:输尿管镜技术由于其适应于泌尿系统腔道的独特特点,可应用于泌尿外科的许多疾病的诊治,尤其对输尿管下段结石可作为首选治疗措施;只要仔细操作,随着经验的积累,并发症发生率会越来越低。
Citation：
HUANG Xiang,ZOU Jianhua,GONG Baisheng,et al.. Clinical Application of Ureteroscope in Manipulation of Urological Diseases (Report of 1333 Cases). West China Medical Journal, 2009, 24(8): 1980-1982. doi:
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- 1. SPRUNGER JK, HERRELL SD 3rd. Techniques of ureteroscopy[J]. Urol Clin North Am, 2004,; 31(1): 61-69.
- 2. 郭应禄.腔内泌尿外科学[M].北京:人民军医出版社,1995:175-176.
- 3. PACE KT, WEIR MJ, TARIQ N, et al. Low success rate of repeat shock wave lithotripsy for ureteral stones after failed initial treatment[J]. J Urol, 2000, 164(6): 1905-1907.
- 4. JOHNSON DB, PEARLE MS. Complications of ureteroscopy[J]. Urol Clin North Am, 2004, 31(1): 157-171.
- 5. SCHUSTER TG, HOLLENBECK BK, FAERBER GJ, et al. Complications of ureteroscopy: analysis of predictive factors[J]. J Urol, 2001, 166(2): 538-540.
