国际泌尿系统杂志
國際泌尿繫統雜誌
국제비뇨계통잡지
INTERNATIONAL JOURNAL OF UROLOGY AND NEPHROLOGY
2013年
1期
6-9
,共4页
输尿管梗阻%肾盂%激光%钬%输尿管镜检
輸尿管梗阻%腎盂%激光%鈥%輸尿管鏡檢
수뇨관경조%신우%격광%화%수뇨관경검
Ureteral obstruction%Kidney Pelvis%Lasers%Holmium%Ureteroscopy
目的 探讨经尿道输尿管镜下钬激光内切开术与离断性肾盂成形术治疗UPJ狭窄的疗效评价.方法 回顾性分析本院2009年～2012年期间收治的120例肾盂输尿管连接部狭窄患者,均经过彩超,肾分泌造影,MRI水成像或逆行造影等明确诊断,患者分为两组,输尿管镜下钬激光内切开术组(58例)和离断性肾盂成形术组(62例),术后所有患者输尿管内留置Fr7号双J管内引流,每3个月行超声、排泄性尿路造影检查.结果 输尿管镜钬激光内切开组手术时间(50.6±15.6)min、术后住院时间(7.5±2.5)d、平均出血量10ml,明显优于开放肾盂成形组(120.6±26.4) min、术后住院时间(16.5±3.6)d、平均出血量200ml(P＜0.05),两组病人术后每3个月复查泌尿系彩超及静脉肾盂造影,随访6～18个月,平均12个月,术后两组肾积水疗效评价,输尿管钬激光内切开组:40例治愈,16例好转,2例手术失败,改行离断性肾盂成形术治愈；开放肾盂成形术组:35例治愈,20例好转,7例无效.结论 肾盂输尿管连接部狭窄的部分病例选择输尿管镜下钬激光内切开术治疗的手术效果可达到开放手术水平、在手术时间、术中出血量、术后住院时间等方面明显优于开放手术组,输尿管镜下钬激光内切开术是一种安全、有效、术后恢复快、创伤小的治疗方法.
目的 探討經尿道輸尿管鏡下鈥激光內切開術與離斷性腎盂成形術治療UPJ狹窄的療效評價.方法 迴顧性分析本院2009年～2012年期間收治的120例腎盂輸尿管連接部狹窄患者,均經過綵超,腎分泌造影,MRI水成像或逆行造影等明確診斷,患者分為兩組,輸尿管鏡下鈥激光內切開術組(58例)和離斷性腎盂成形術組(62例),術後所有患者輸尿管內留置Fr7號雙J管內引流,每3箇月行超聲、排洩性尿路造影檢查.結果 輸尿管鏡鈥激光內切開組手術時間(50.6±15.6)min、術後住院時間(7.5±2.5)d、平均齣血量10ml,明顯優于開放腎盂成形組(120.6±26.4) min、術後住院時間(16.5±3.6)d、平均齣血量200ml(P＜0.05),兩組病人術後每3箇月複查泌尿繫綵超及靜脈腎盂造影,隨訪6～18箇月,平均12箇月,術後兩組腎積水療效評價,輸尿管鈥激光內切開組:40例治愈,16例好轉,2例手術失敗,改行離斷性腎盂成形術治愈；開放腎盂成形術組:35例治愈,20例好轉,7例無效.結論 腎盂輸尿管連接部狹窄的部分病例選擇輸尿管鏡下鈥激光內切開術治療的手術效果可達到開放手術水平、在手術時間、術中齣血量、術後住院時間等方麵明顯優于開放手術組,輸尿管鏡下鈥激光內切開術是一種安全、有效、術後恢複快、創傷小的治療方法.
목적 탐토경뇨도수뇨관경하화격광내절개술여리단성신우성형술치료UPJ협착적료효평개.방법 회고성분석본원2009년～2012년기간수치적120례신우수뇨관련접부협착환자,균경과채초,신분비조영,MRI수성상혹역행조영등명학진단,환자분위량조,수뇨관경하화격광내절개술조(58례)화리단성신우성형술조(62례),술후소유환자수뇨관내류치Fr7호쌍J관내인류,매3개월행초성、배설성뇨로조영검사.결과 수뇨관경화격광내절개조수술시간(50.6±15.6)min、술후주원시간(7.5±2.5)d、평균출혈량10ml,명현우우개방신우성형조(120.6±26.4) min、술후주원시간(16.5±3.6)d、평균출혈량200ml(P＜0.05),량조병인술후매3개월복사비뇨계채초급정맥신우조영,수방6～18개월,평균12개월,술후량조신적수료효평개,수뇨관화격광내절개조:40례치유,16례호전,2례수술실패,개행리단성신우성형술치유；개방신우성형술조:35례치유,20례호전,7례무효.결론 신우수뇨관련접부협착적부분병례선택수뇨관경하화격광내절개술치료적수술효과가체도개방수술수평、재수술시간、술중출혈량、술후주원시간등방면명현우우개방수술조,수뇨관경하화격광내절개술시일충안전、유효、술후회복쾌、창상소적치료방법.
Objectives To comparisrion the therapeutic effect of ureteroscopic endotomy using Ho:YAG laser with Dismembered pyeloplasty for recurrent ureteropelvic junction obstruction.Methods From 2009 to 2011,120 patients with recurrent ureteropelvic junction obstruction,of these patients,58 cases underwent ureteroscopic endotomy and 62 cases underwent dismembered pyeloplasty,a 7F D-J catheter was inserted,the operative time,average intraoperative blood loss and postoperative length of hospital stay of the two groups were analyzed.Results The ureteroscopic endotomy group had fewer operative time(50.6 ± 15.6min vs 120.6 ± 26.4min,P ＜0.05),shorter postoperative length of hospital stay(7.5 ± 2.5d vs 16.5 ± 3.6d,P ＜ 0.05),the mean intraoperative blood loss was 10ml vs 200ml in the open group(P ＜0.05),69％ cure rate and 28％ improvement rate in the ureteroscopic endotomy group and 56％ cure rate and 30％ improvement in the open group at a follow up of 6 ～ 18months.Conclusions
