输尿管镜球囊扩张术在良性输尿管狭窄中的应用

发布时间：2018-07-23 11:16

【摘要】：目的探讨输尿管镜球囊扩张术治疗良性输尿管狭窄(US)的临床效果。方法回顾性分析输尿管镜下球囊扩张治疗18例US患者资料。男8例,女10例,年龄21~73岁,平均42岁。其中狭窄17例,闭锁1例。窄段长度0.5 cm 10例,0.5~1.5 cm 6例,1.5 cm以上2例。狭窄段位于肾盂输尿管连接部3例,上段4例,中段4例,下段7例。结果 18例患者均在输尿管镜引导下找到正确通道,完成球囊扩张手术。留置单条7F输尿管内支架管10例,留置双条5F输尿管支架管8例。17例留置双J管6~12个月,1例患者留置双J管3个月。术后随访12~36个月,10例一次手术扩张有效。6例拔管半年后再次狭窄,行二次球囊扩张后有效。2例输尿管肾孟的接合处(UPJ)狭窄段过长,肾滤过功能均小于20 ml/min,术后1年复查,再次狭窄,行后腹腔镜下UPJ整形术后有效。结论输尿管镜球囊扩张术是治疗US安全、有效的手术方法,可以作为US长度在1.5 cm以内的单侧肾功能轻-中度损害的US的首选方案。
[Abstract]:Objective to investigate the clinical effect of ureteroscopic balloon dilatation for benign ureteral stenosis (US). Methods the data of 18 patients with US treated by ureteroscopic balloon dilation were retrospectively analyzed. Male 8 cases, female 10 cases, the age is 21 73 years old, average 42 years old. There were 17 cases of stenosis and 1 case of atresia. The length of the narrow segment was 0.5 cm in 10 cases, 0.5 and 1.5 cm in 6 cases and above 1.5 cm in 2 cases. The stenosis was located in the junction of ureteropelvic junction in 3 cases, upper segment in 4 cases, middle segment in 4 cases and lower segment in 7 cases. Results all the 18 patients found the correct passage under ureteroscope and performed balloon dilatation. There were 10 cases with single 7F ureteral stents, 8 cases with double 5F ureteral stents, 17 cases with double J tubes for 6 ~ 12 months and 1 case with double J tubes for 3 months. Ten cases were followed up for 12 ~ 36 months. 6 cases were re-stenosis after extubation for half a year. After secondary balloon dilatation, 2 cases had long ureteral junction (UPJ), renal filtration function was less than 20 ml / min, and reexamined 1 year after operation. Stricture again, after retroperitoneal laparoscopic UPJ plastic surgery is effective. Conclusion Ureteroscopic balloon dilatation is a safe and effective method for the treatment of US. It can be used as the first choice of US in unilateral renal function with mild to moderate damage in length of less than 1.5 cm.
【作者单位】：广州中医药大学附属广东省中医院泌尿外科;
【分类号】：R699.4

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