目的:探討輸尿管鏡技術在泌尿外科疾病診治中的臨床應用價值。方法: 2002年9月至2008年9月應用經尿道輸尿管鏡技術診斷和治療泌尿系疾病患者1333例。其中行輸尿管鏡治療者1200例, 包括輸尿管結石1010例,其中上段結石146例、中段344例、下段520例;輸尿管狹窄18例;醫源性雙J管滯留38例;男性尿道狹窄38例;膀胱尿道結石41例;腎盂結石8例;輸尿管陰道漏5例;小兒逆行輸尿管插管20例;內支架管置入22例。其中用于診斷的患者133例。結果:治療1010例輸尿管結石,成功865例,成功率為85.6%,其中治療輸尿管上、中、下段結石的成功率分別為68.5%、81.7%及93.1%;輸尿管狹窄、尿道狹窄、膀胱尿道結石、輸尿管陰道漏及小兒逆行輸尿管插管均療效滿意。用于診斷的133例患者中,發現腫瘤4例,陰性結石48例,息肉8例,輸尿管結核9例,輸尿管狹窄30例,無陽性發現34例。手術失敗24例。發生嚴重手術并發癥37例,其中死亡1例,感染性休克2例,黏膜撕脫4例,穿孔15例、假道12例,嚴重出血3例。結論:輸尿管鏡技術由于其適應于泌尿系統腔道的獨特特點,可應用于泌尿外科的許多疾病的診治,尤其對輸尿管下段結石可作為首選治療措施;只要仔細操作,隨著經驗的積累,并發癥發生率會越來越低。
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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- 2. 郭應祿.腔內泌尿外科學[M].北京:人民軍醫出版社,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.
