CAJ | 학술논문

目的探讨筋膜扩张器在处理女性输尿管下段嵌顿性结石中的实用价值.方法选取17例女性输尿管下端结石嵌顿病例.输尿管镜下将斑马导丝顺利置入输尿管内,利用筋膜扩张器扩张输尿管下段,再通过输尿管镜或辅以Peel-away剥皮鞘行气压弹道或钬激光碎石、取石术.术后复查KUB了解输尿管内结石清除效果及双J管位置.结果 16例患者一期碎石、排石成功;1例合并糖尿病病例因结石梗阻伴有上尿路积脓,先行留置双J管,于抗感染处理后二期予以筋膜扩张器扩张下输尿管镜碎石术,术后效果理想.结论将筋膜扩张器应用于处理女性输尿管下段嵌顿结石,尤其是针对输尿管壁内段或结石远端输尿管伴有狭窄而进镜困难的病例,可减小手术创伤,节省手术时间,大大提高清石率及降低开放率,是一种安全、有效、值得推崇的实用方法.
목적 탐토근막확장기재처리녀성수뇨관하단감돈성결석중적실용개치.방법 선취17례녀성수뇨관하단결석감돈병례.수뇨관경하장반마도사순리치입수뇨관내,이용근막확장기확장수뇨관하단,재통과수뇨관경혹보이Peel-away박피초행기압탄도혹화격광쇄석、취석술.술후복사KUB료해수뇨관내결석청제효과급쌍J관위치.결과 16례환자일기쇄석、배석성공;1례합병당뇨병병례인결석경조반유상뇨로적농,선행류치쌍J관,우항감염처리후이기여이근막확장기확장하수뇨관경쇄석술,술후효과이상.결론 장근막확장기응용우처리녀성수뇨관하단감돈결석,우기시침대수뇨관벽내단혹결석원단수뇨관반유협착이진경곤난적병례,가감소수술창상,절성수술시간,대대제고청석솔급강저개방솔,시일충안전、유효、치득추숭적실용방법.
Objectives To evaluate the clinical usage of Renal Sheath Dilator in treating distal ureteral stones.Methods 17 patients with incarcerated ureteral calculi were selected.Zebra guidewire was placed with ureteroscope and renal sheath dilator was inserted serially to dilate the stricture under ureteroscope monitor.Ureteral calculi were managed with pneumatic ballistic or holmium laser through the ureteroscope or supplemented with Peelaway.KUB was veexamined to get the known of the efficacy of the stone clearance and the position of the double Jstent after the operation.Results 16 patients had completely success with one stage operation.One case of diabetes patient with upper urinary tract empyema due to stones obstruction was indwellt double J-stent at first,and after anti-infection treatment,a second procedure was performed.The result was successful.Conclusions The renal sheath dilator used in treatment of incarcerated women lower ureteral calculi,especially for the ureteral wall segments or distal ureteral calculi with narrow and difficult cases into the mirror,can reduce surgical trauma,save time and greatly improve stone clearance rate and reduce the rate of change to open surgery.It is a safe,effective and worthy method for promoting.