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目的:探讨采用输尿管硬镜治疗输尿管中下段结石的技巧。方法:2010年1月至2015年8月我院采用输尿管硬镜治疗输尿管中下段结石80例,术前均经B超、CT、KUB平片或IVU确诊为输尿管中下段结石伴肾积水以及输尿管扩张,结石位于左侧42例,右侧38例,结石大小0.6一1.2cm,14例合并息肉。结果:本组80例患者,78例镜下碎石成功,成功率97.5%(58/60);2例进镜失败中转开放手术治疗。14例合并息肉者同时行息肉切除术,切除率达100%(14/14)。本组未见严重手术并发症发生。78例术后随访2—4周,未见肾、输尿管扩张积水及结石残留。结论:输尿管硬镜顺利进入输尿管口是减少损伤、提高输尿管末端结石碎石成功的关键。
Objective: To explore the use of ureteral calculi in the treatment of stones in the lower ureter tips. Methods: From January 2010 to August 2015, 80 cases of ureteral calculi in our hospital were treated by ureteroscopy. All patients were diagnosed as middle and lower ureteral calculi with hydronephrosis by B-mode ultrasound, CT, KUB plain radiography or IVU before operation. Ureteral dilatation, stones in the left side of 42 cases, the right side of 38 cases, the size of stones 0.6 a 1.2cm, 14 cases of polyps. Results: In this group of 80 patients, 78 cases of gravel succeeded, the success rate was 97.5% (58/60); 2 cases failed to turn the door open surgery. Fourteen patients with polyps underwent polypectomy at the same time. The resection rate was 100% (14/14). No serious complications occurred in this group. 78 cases were followed up for 2-4 weeks, no kidney, ureteral dilatation and residual stones. Conclusions: The ureteroscopic smooth entry into the ureter orifice is the key to reduce the damage and improve the success of ureteral calculi.