CAJ | 학술논문

[目的]探讨输尿管镜钬激光治疗输尿管结石的并发症的原因及预防措施。[方法]2010年4月至2013年3月，本院112例输尿管结石采用F9号w o lf输尿管镜钬激光碎石系统治疗的临床资料进行分析。[结果]在治疗过程中有20例发生了不同程度的并发症，包括输尿管镜置入失败3例；输尿管损伤（穿孔，黏膜下隧道）及膀胱损伤共5例，其中2例放置D-J管后治愈，余3例开放手术取石并修复损伤的输尿管；输尿管碎石过程中全部或部分结石上移至肾盂9例，术后行体外振波碎石（ESWL ）治愈。术后感染高热2例，其中1例发生感染性休克。术后严重血尿1例。[结论]针对各并发症不同原因，采取相应措施干预，能有效地预防和处理各并发症，其关键在于术前认真准备，术中娴熟而仔细的操作。
[목적]탐토수뇨관경화격광치료수뇨관결석적병발증적원인급예방조시。[방법]2010년4월지2013년3월，본원112례수뇨관결석채용F9호w o lf수뇨관경화격광쇄석계통치료적림상자료진행분석。[결과]재치료과정중유20례발생료불동정도적병발증，포괄수뇨관경치입실패3례；수뇨관손상（천공，점막하수도）급방광손상공5례，기중2례방치D-J관후치유，여3례개방수술취석병수복손상적수뇨관；수뇨관쇄석과정중전부혹부분결석상이지신우9례，술후행체외진파쇄석（ESWL ）치유。술후감염고열2례，기중1례발생감염성휴극。술후엄중혈뇨1례。[결론]침대각병발증불동원인，채취상응조시간예，능유효지예방화처리각병발증，기관건재우술전인진준비，술중한숙이자세적조작。
[Objective]To explore the causes and preventive measures for complications of ureteroscopic Holmium laser lithotripsy in the treatment of ureteral calculi .[Methods]From April 2010 to March 2013 ,112 cases of ureteral calculi were treated with F9 Wolf ureteroscopic Ho :YAG gravel system in our hospital .A-mong them ,21 cases were upper segment ureteral calculi ,and 12 cases were middle segment ureteral calculi , and 79 cases were lower segment ureteral calculi .[Results] In the course of treatment ,intraoperative compli-cations in different degree occurred in 20 cases including 3 cases of the failure of ureteroscopy and 5 cases of u-reteral injury (perforation and submucosal tunnel) and bladder injury in which 2 cases were cured by the place-ment of double-J stent and the other 3 cases were converted to open surgery to repair the injured ureters .In the process of ureteral gravel ,all or some of the stones in 9 cases moved up into renal pelvis ,and were cured with ESWL after operation .Postoperative infection and high fever occurred in 2 cases in which one case suffered from infective shock .Postoperative severe hematuria occurred in one case .[Conclusion]The causes of the com-plications and appropriate preventive measures are found through the analysis and summary of common compli-cation in the process of ureteroscopic gravel .