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目的探讨输尿管镜的临床应用。方法回顾性分析输尿管镜治疗72例患者临床资料,根据进入途径不同分为:经尿道输尿管镜组55例,经皮肾微创输尿管镜碎石组17例两组。结果经尿道输尿管镜组应用输尿管镜技术顺利取出异物9例、置双J管治疗输尿管阴道瘘6例中有5例成功,1例为输尿管缝扎进镜受阻而改行开放手术。在输尿管镜气弹道碎石(URL)治疗输尿管中下段结石40例中治愈38例,成功率90.5%,1例术中出现输尿管穿孔,1例进镜受阻改行开放手术;微创经皮肾输尿管镜取石术(MPCNL)17例,其中12例一次取尽结石,1例穿刺后见肾内集合系统视野不清改开放手术,4例因积液感染行II期MPCNL,2例二次取尽结石,另2例结合ESWL治愈。结石总取净率为93.9%。结论输尿管镜对尿路疾病的诊断和治疗具有广阔的应用前景。
Objective To investigate the clinical application of ureteroscopy. Methods Retrospective analysis of 72 cases of ureteroscopic treatment of clinical data, according to different access routes are divided into: transurethral ureteroscopy 55 cases, percutaneous renal minimally invasive ureteroscopic lithotripsy 17 cases of two groups. Results The transurethral ureteroscopic ureteroscopic technique successfully removed foreign bodies in 9 cases, double J tube treatment of ureteral fistula in 6 cases, 5 cases were successful, 1 case of ureteral sutured into the mirror blocked and diverted to open surgery. 38 cases were cured in 40 cases of ureteroscopic pneumatic ballistic lithotripsy (URL) for ureteral calculi, with a success rate of 90.5%. One case had perforation of the ureter and one case had the obstruction of the ureter open. The minimally invasive percutaneous nephrolithotomy Seventeen patients underwent MPCNL, of which 12 had complete stone removal at one time, one had a clear view of renal collecting system after open puncture, 4 had MPCNL due to effusion, and 2 had MPCNL twice Stone, the other two cases combined with ESWL cure. Total stone removal rate was 93.9%. Conclusion Ureteroscopy has broad application prospects in the diagnosis and treatment of urinary tract diseases.