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目的:了解输尿管结石合并的输尿管炎性息肉在无结石刺激情况下的变化及自然转归。方法:收集2012年6月~2014年1月治疗的输尿管下段结石合并的输尿管炎性息肉患者35例,共分A、B、C三组。每例均行钬激光充分碎石及术中息肉活检。A组5例:术中钬激光彻底切除输尿管息肉;B组15例:术中切除部分输尿管息肉;C组15例:术中输尿管息肉不处理。三组患者术后留置双J管内引流4周,1年后行输尿管镜检查,了解息肉变化。结果:35例患者均行病理检查证实合并输尿管炎性息肉,A组术后有2例出现输尿管狭窄,B组术后1年复查输尿管镜均未发现输尿管息肉,3例原结石停留处见黏膜局限性隆起,无输尿管狭窄发生;C组术中输尿管息肉不处理,术后1年复查输尿管镜,7例未见息肉,4例见黏膜局限性隆起,4例见息肉。结论:对于输尿管结石合并的输尿管炎性息肉,建议术中部分处理息肉。完全切除息肉易发生输尿管狭窄;不处理息肉,其将仍然存在。
OBJECTIVE: To understand the changes and natural outcome of ureteral polyps with ureteral stones without stoma stimulation. Methods: A total of 35 patients with ureteral polyps from June 2012 to January 2014 were enrolled in this study. The patients were divided into three groups: A, B and C. All patients underwent holmium laser lithotripsy and intraoperative polyp biopsy. A group of 5 patients: intraoperative holmium laser radical resection of ureteral polyps; B group of 15 patients: partial resection of ureteral polyps; C group of 15 patients: intraoperative ureteral polyps not treated. Three groups of patients were placed in double J tube drainage after 4 weeks, 1 year after ureteroscopy to understand changes in polyps. Results: All the 35 patients underwent pathological examination with ureteral polyps, 2 patients had ureteral stricture after operation in group A, no ureteral polyps were observed in ureteroscope at 1 year after operation in group A, and mucosa was observed in 3 patients The urethral polyps were not treated in group C, ureteroscopy was performed one year after operation, no polyps were observed in 7 cases, mucosal limitations were found in 4 cases, and polyps were found in 4 cases. Conclusions: For ureteral polyps with ureteral calculi, it is advisable to partially treat the polyps during surgery. Complete resection of polyps prone to ureteral stricture; non-treatment of polyps, which will still exist.