CAJ | 학술논문

目的：探讨经皮肾穿刺经尿道建立导丝轨道置入双J管治疗输尿管狭窄和梗阻的方法并评价其疗效。方法75例输尿管狭窄或梗阻患者（其中良性狭窄60例，恶性狭窄15例）在膀胱镜插管失败情况下，均采用经皮肾穿刺经尿道建立导丝轨道，沿导丝轨道经尿道置入球囊导管扩张狭窄段并置入双J管。随访3个月至5年。结果手术成功率98.7%（74/75），良性狭窄患者中1例失败。治愈率70.7%（53/75），好转率26.7%（20/75），无效1例（1.35%），总有效率97.3%（73/75）。结论经皮肾穿刺经尿道建立导丝轨道置入双J管治疗输尿管狭窄和梗阻是一种安全有效的方法。
목적：탐토경피신천자경뇨도건립도사궤도치입쌍J관치료수뇨관협착화경조적방법병평개기료효。방법75례수뇨관협착혹경조환자（기중량성협착60례，악성협착15례）재방광경삽관실패정황하，균채용경피신천자경뇨도건립도사궤도，연도사궤도경뇨도치입구낭도관확장협착단병치입쌍J관。수방3개월지5년。결과수술성공솔98.7%（74/75），량성협착환자중1례실패。치유솔70.7%（53/75），호전솔26.7%（20/75），무효1례（1.35%），총유효솔97.3%（73/75）。결론경피신천자경뇨도건립도사궤도치입쌍J관치료수뇨관협착화경조시일충안전유효적방법。
Objective To explore the technique of implantation of double-J stent via the guide-wire track, which was established through percutaneous renal puncturing, for the treatment of ureteral stricture and obstruction, and to evaluate its therapeutic effect. Methods A total of 75 patients with ureteral stricture or obstruction, who failed to respond to cystoscopic catheterization, were enrolled in this study. The lesions included benign stricture(n=60) and malignant stricture(n=15). Ureteral guide-wire track was established through percutaneous renal puncturing, which was followed by the dilatation of the stricture with balloon catheter and subsequent implantation of double-J stent via the guide-wire track. After the double-J stent was removed, the patients were followed up for 3 months to five years. Results The success rate of the procedure was 98.7%(74/75). Technical failure occurred in one patient with benign ureteral stricture. The cure rate was 70.7%(53/75), the improvement rate was 26.7%(20/75), and no improvement was seen in one case (1.35%). The total effective rate was 97.3%(73/75). Conclusion For the treatment of ureteral stricture and obstruction, the implantation of double-J stent via the guide-wire track, which is established through percutaneous renal puncturing, is a safe and effective method.