CAJ | 학술논문

目的：：利用改良 Satava classificati on syste m 评估新疆维吾尔自治区医院及江西新余地区医院经输尿管镜处理输尿管结石的经验及并发症。方法：回顾性分析1563例经输尿管镜处理输尿管结石的患者(男877例,女686例),根据改良Satava classificati on syste m 评估手术并发症分为1~3级,1级为有并发症但不需处理没有任何不良后果的,2级为并发症需要经内镜在术中处理(2a )或术后内镜处理的(2 b ),3级为并发症需要开放或腹腔镜处理的。结果：经输尿管镜碎石取石术后完全取出或结石碎片自行排出的1348例(86.2％)。手术并发症总发生率为216例(13.8％),其中输尿管上段结石移位进入肾盂为4.6％,黏膜损伤3.8％,出血2.3％,输尿管镜不能进入到达结石部位2.1％,黏膜下假道3.15％,输尿管穿孔1.15％,输尿管撕裂伤脱套0.13％。根据改良 Satava classificati on syste m评估：1级的为4.9％,2级a 为4.6％,b 为3.74％,3级为0.56％。结论：改良Satava classificati on syste m 对于经输尿管镜处理输尿管结石出现的并发症严重程度有较好的描述作用,可指导正确的临床处理和评估并发症的预后,同时也可以用来与其他文献比较而更好的服务于临床工作。
목적：：이용개량 Satava classificati on syste m 평고신강유오이자치구의원급강서신여지구의원경수뇨관경처리수뇨관결석적경험급병발증。방법：회고성분석1563례경수뇨관경처리수뇨관결석적환자(남877례,녀686례),근거개량Satava classificati on syste m 평고수술병발증분위1~3급,1급위유병발증단불수처리몰유임하불량후과적,2급위병발증수요경내경재술중처리(2a )혹술후내경처리적(2 b ),3급위병발증수요개방혹복강경처리적。결과：경수뇨관경쇄석취석술후완전취출혹결석쇄편자행배출적1348례(86.2％)。수술병발증총발생솔위216례(13.8％),기중수뇨관상단결석이위진입신우위4.6％,점막손상3.8％,출혈2.3％,수뇨관경불능진입도체결석부위2.1％,점막하가도3.15％,수뇨관천공1.15％,수뇨관시렬상탈투0.13％。근거개량 Satava classificati on syste m평고：1급적위4.9％,2급a 위4.6％,b 위3.74％,3급위0.56％。결론：개량Satava classificati on syste m 대우경수뇨관경처리수뇨관결석출현적병발증엄중정도유교호적묘술작용,가지도정학적림상처리화평고병발증적예후,동시야가이용래여기타문헌비교이경호적복무우림상공작。
Objective :To revie wi ntraoperati ve co mplicati ons foll o wi ng ureteroscopy lithotri psy (URL )accordi ng to our experience with URL i n the treat ment of ureteral stones and stratify i ntraoperati ve co mplicati ons foll o wi ng URL accordi ng to the modified Satava classificati on syste m.Methods :The cli nical data of 1 563 patients (877 males and 686 fe males )were retrospecti vel y .Intraoperati ve co mplicati ons were recorded accordi ng to modified Satava clas-sificati on syste m.Grade 1 co mplicati ons i ncl uded i nci dents without consequences for the patients ;grade 2 co mplica-ti ons ,which are treated i ntraoperati vel y with endoscopic surgery (grade 2a )or required endoscopic re-treat ment (grade 2 b );and grade 3 co mplicati ons i ncl uded i nci dents requiri ng open or laparoscopic surgery .Results :The stones were co mpletel y re moved i n 1 348 (86.3 %).The overall i nci dence of i ntraoperati ve co mplicati ons was 1 3.8 %.The most co mmon co mplicati ons were proxi mal stone mi grati on (4.6 %),mucosal i nj ury (3.8 %),bleedi ng (2.3 %), i nability to reach stone (2 .1 %),ureteral perforati on (1 .1 5 %)and ureteral avulsi on (0.1 3 %),mucosal tears or false-route (3.1 5 %).Accordi ng to modified Satava classificati on syste m,grade 1 accounted for 4.9 %,grade 2a for 4.6 %,grade 2 b for 3.74 %,and grade 3 for 0.56 % respecti vel y .Conclusions :Modified Satava classificati on is a quick and si mple syste m for usi ng to descri b the severity of i ntraoperati ve URL co mplicati ons and this gradi ng sys-te m will hel p to co mpare for the available surgical outco mes fro m different centers .