CAJ | 학술논문

目的探讨输尿管镜下电切加球囊扩张术治疗输尿管狭窄的临床疗效. 方法回顾性分析2008年6月至2011年6月收治的49例输尿管狭窄患者的临床资料,其中,男20例,女29例,年龄15 ～56岁,平均40岁.患侧肾功能轻度受损者4例,中度受损者35例,重度受损者10例.肾盂输尿管连接处狭窄11例.输尿管上段狭窄13例,中下段狭窄25例.狭窄段长度0.3～2.0 cm,平均为1.2 cm.其中经皮肾微穿刺输尿管镜下电切加球囊扩张术治疗17例,经尿道输尿管镜下完成31例.双J管留置3～6个月,45例患者获随访,随访时间12～43个月,平均24个月.结果 48例手术顺利完成,1例中转开放行肾盂输尿管连接部成形术.手术时间25～95 min,平均42 min；术后住院时间2-6d,平均4d.45例随访复查B超及CT示肾积水明显减轻39例,IVU示输尿管显影通畅无明显狭窄；肾积水无明显变化6例. 结论输尿管镜直视下电切结合球囊扩张治疗输管狭窄手术效果确切、痛苦小、术后恢复快、住院时间短,为输尿管狭窄患者提供新的有效治疗方法.
목적 탐토수뇨관경하전절가구낭확장술치료수뇨관협착적림상료효. 방법 회고성분석2008년6월지2011년6월수치적49례수뇨관협착환자적림상자료,기중,남20례,녀29례,년령15 ～56세,평균40세.환측신공능경도수손자4례,중도수손자35례,중도수손자10례.신우수뇨관련접처협착11례.수뇨관상단협착13례,중하단협착25례.협착단장도0.3～2.0 cm,평균위1.2 cm.기중경피신미천자수뇨관경하전절가구낭확장술치료17례,경뇨도수뇨관경하완성31례.쌍J관류치3～6개월,45례환자획수방,수방시간12～43개월,평균24개월.결과 48례수술순리완성,1례중전개방행신우수뇨관련접부성형술.수술시간25～95 min,평균42 min；술후주원시간2-6d,평균4d.45례수방복사B초급CT시신적수명현감경39례,IVU시수뇨관현영통창무명현협착；신적수무명현변화6례. 결론 수뇨관경직시하전절결합구낭확장치료수관협착수술효과학절、통고소、술후회복쾌、주원시간단,위수뇨관협착환자제공신적유효치료방법.
Objective To investigate the efficacy of transurethral resection and ball pouch dilatation for treatment of ureterostenosis. Methods The clinical data of 49 cases of ureteral stricture were analyzed retrospective analysis from June 2008 to June 2011 with 20 cases of male patients and 29 cases of female patients.The age was 15 to 56 years,with a mean age of 40 years.Ipsilateral renal function were mild impairment in 4 cases,moderate impairment in 35 cases,and severe damage in 10 cases.There were ureteropelvic junction etenosis in 11 cases,upper ureteral stricture in 13 cases,and lower segment stenosis in 25 cases.The ureteral stricture length was 0.3 to 2.0 cm,with a mean of 1.2 cm.Seventeen patients were treated with transurethral resection and ball pouch dilatation by minimally invasive percutaneous nephrostomy,and 31 cases were completed by ureteroscopy.The ureteral stents were removed by ureteroscope after 3 - 6 months.45 cases were followed up for 12 -43 months,with a mean of 24 months. Results Forty-eight cases were completed smoothly with 1 case converted to open surgery.The surgical time was 25 to 95 min with a mean of 42 min.The postoperative hospital stay was 2 to 6 d with a mean of 4 d.In the follow-up of 45 cases,B ultrasound and CT scan showed hydronephrosis reduced significantly in 39 patients,IVU showed unobstructed ureter without significant stenosis.And 6 cases showed no significant changes in hydronephrosis. Conc(t)usion The method of transurethral resection and ball pouch dilatation has good clinical effect,less pain and shorter hospital stays,which provides a new and effective treatment for patients with ureteral stricture.