CAJ | 학술논문

目的分析输尿管镜手术造成医源性损伤的主要原因并制定相应的防治对策。方法回顾性研究2004年至2009年间的2683例输尿管镜诊疗的病例，其中造成医源性损伤共36例，分析其发生原因，根据原因来探究防治对策。结果 36例医源性损伤的病例中，27例输尿管穿孔留置DJ管4～8周后痊愈。3例输尿管断离及时行开放手术吻合成功。4例输尿管大出血，药物及手术治疗后出血停止。2例输尿管闭锁导致患肾无功能，最后行肾脏切除。结论输尿管镜是泌尿外科常用的微创技术，如操作不当可导致严重并发症，防止并发症的关键就是掌握好适应征和提高输尿管操作技巧。
목적 분석수뇨관경수술조성의원성손상적주요원인병제정상응적방치대책。방법 회고성연구2004년지2009년간적2683례수뇨관경진료적병례，기중조성의원성손상공36례，분석기발생원인，근거원인래탐구방치대책。결과 36례의원성손상적병례중，27례수뇨관천공류치DJ관4～8주후전유。3례수뇨관단리급시행개방수술문합성공。4례수뇨관대출혈，약물급수술치료후출혈정지。2례수뇨관폐쇄도치환신무공능，최후행신장절제。결론수뇨관경시비뇨외과상용적미창기술，여조작불당가도치엄중병발증，방지병발증적관건취시장악호괄응정화제고수뇨관조작기교。
Objectives To analyze the causes of iatrogenic injury made by ureteroscopy and decide the corresponding preventive treatment. Methods To retrospectively study 2683 cases which have ureteroscopy. 36 cases occur iatrogenic injury. to analyze the major causes, then find out the countermeasure. Results Among of 36 cases wich occur iatrogenic injury, 27 cases ureteral perforation are recovered completely retemting D - J tube in 4 - 8 weeks. 3 cases ureteral iridodialysis are cured with ureteroureterostomy, 4 cases ureteral hemorrhage bleeding stop by means of hemostatic and operation. 2 cases ureteral atresia leading to no functional kidney, finally take nephre - ctomy. Conclusions Ureteroscopy is a kind of urological minimally invasive surgery that is frequently - used. Serious complications will happen easily in case of misoperation. The key of preventive treatment is well mastering indications and enhancing the skill of uroteroscopy.