输尿管开口电切术联合输尿管镜治疗输尿管结石16例
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摘要
目的探讨输尿管开口电切联合输尿管镜治疗输尿管结石的可行性及疗效。方法选取2015年1月至2016年3月,宣城市人民医院收治16例输尿管结石行输尿管镜失败的病人,先行经尿道输尿管开口处电切,暴露结石或输尿管开口后行输尿管镜下取石或钬激光碎石术。结果 4例病人行电切后输尿管镜下取石,12例病人行输尿管镜下钬激光碎石。经过2～24月的观察,所有病人的肾积水改善,无输尿管开口狭窄或返流。结论输尿管开口电切联合输尿管镜治疗输尿管结石是有效、可行的治疗方法,但需注意术中操作技巧。
Objective To evaluate the feasibility and effect of transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy in the treatment of ureteral calculi.Methods Sixteen patients who failed in the ureteroscopy treatment in the People's Hospitial of Xuancheng City from January 2015 to March 2016 received transurethral resection of the ureter opening, and then completely removed the stone or combined with ureteroscopy with holmium laser lithotripsy.Results The stones in four cases could be completely removed by transurethral resection of the ureter opening. The other 12 cases have been cured by transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy.After 2～ 24 months observation, hydronephrosis in all patients have been dissipated, and there was no report of ureteral stenosis or regurgitation. Conclusions Transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy is feasible and effective in the treatment of ureteral calculi, but urological surgeons need to pay attention to intraoperative skills.
Objective To evaluate the feasibility and effect of transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy in the treatment of ureteral calculi.Methods Sixteen patients who failed in the ureteroscopy treatment in the People's Hospitial of Xuancheng City from January 2015 to March 2016 received transurethral resection of the ureter opening, and then completely removed the stone or combined with ureteroscopy with holmium laser lithotripsy.Results The stones in four cases could be completely removed by transurethral resection of the ureter opening. The other 12 cases have been cured by transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy.After 2～ 24 months observation, hydronephrosis in all patients have been dissipated, and there was no report of ureteral stenosis or regurgitation. Conclusions Transurethral resection of the ureter opening combined with ureteroscopy with holmium laser lithotripsy is feasible and effective in the treatment of ureteral calculi, but urological surgeons need to pay attention to intraoperative skills.
引文
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[9]江顺,金能成,郭志文,等.后腹腔镜与输尿管镜治疗输尿管上段结石的效果比较[J].安徽医药,2014,18(6):1101-1103.
[10]李武学,赵兴华,许长宝,等.输尿管镜治疗复杂性输尿管结石留置双J管时间的临床观察[J].实用医学杂志,2017,33(2):256-258.
[2]秦允清,曹用立,张有印,等.输尿管结石行输尿管镜下气压弹道碎石术失败原因分析[J].江西医药,2015,50(7):668-670.
[3]黄喜健,吴定涛,闭克明,等.输尿管下段结石并狭窄的微创治疗[J].微创医学,2013,8(3):372-374.
[4]陈奎,刘仁滨,黄海波,等.硬性输尿管镜入镜困难的探讨[J].广州医学院学报,2011,39(4):55-56,71.
[5]丁俊峰,王冰捷.经尿道电切治疗输尿管口附近表浅膀胱肿瘤[J].中国现代药物应用,2010,4(7):109-110.
[6]刘定益,俞家顺,王健,等.输尿管镜钬激光治疗输尿管结石1015例疗效分析[J].中国微创外科杂志,2015,15(8):695-698.
[7]楼水鑫,丁青,任黎刚,等.输尿管镜联合电切镜治疗输尿管末端结石疗效分析[J].浙江医学,2011,33(6):833-835.
[8]仝墨泽,刘见辉,陶汉寿,等.经输尿管镜钬激光碎石术与气压弹道碎石术治疗输尿管结石的临床疗效比较[J].安徽医药,2014,18(5):887-889.
[9]江顺,金能成,郭志文,等.后腹腔镜与输尿管镜治疗输尿管上段结石的效果比较[J].安徽医药,2014,18(6):1101-1103.
[10]李武学,赵兴华,许长宝,等.输尿管镜治疗复杂性输尿管结石留置双J管时间的临床观察[J].实用医学杂志,2017,33(2):256-258.