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目的:观察内窥镜手术切除输尿管膨出的治疗效果。方法:回顾性分析 13 例成人输尿管膨出患者采用内窥镜手术治疗的临床资料。结果:13例患者均经 IVU、B超及膀胱镜检查确诊,采用电切镜或钬激光机行输尿管囊肿低位横行切开术5例,3例肾积水消失,2 例肾积水改善;8 例行输尿管膨出囊壁部分切除,积水全部消失。均一次手术成功,术后平均随访18个月,3例术后出现输尿管反流,2 例 2 个月后自行缓解,1 例于术后 4个月行开放手术抗反流。结论:内窥镜手术切除输尿管膨出是一种安全、简单、有效的治疗方法,可以减少手术创伤及术后并发症,创伤小、恢复快。囊壁部分切除术效果更为理想。当输尿管反流不能自愈时,应行输尿管膀胱抗反流吻合术。
Objective: To observe the therapeutic effect of ureteral bulking by endoscopic surgery. Methods: A retrospective analysis of 13 cases of adult ureteral bulging patients with endoscopic surgical treatment of clinical data. Results: Thirteen patients were diagnosed by IVU, B ultrasound and cystoscopy. Five cases were underwent resection of ureter cyst by using resectoscope or holmium laser, 3 cases of hydronephrosis disappeared and 2 cases of hydronephrosis improved. 8 cases of ureteral bulging partial resection of the wall, water disappeared. All patients were operated successfully. The patients were followed up for an average of 18 months. Three patients had ureteral reflux after surgery. Two patients resolved spontaneously after two months. One patient underwent open surgery 4 months after operation. Conclusions: Endoscopic surgical removal of ureteral bullae is a safe, simple and effective treatment, which can reduce the surgical trauma and postoperative complications, less trauma and faster recovery. Partial wall resection effect is more ideal. When the ureter reflux can not be self-healing, ureteric bladder anti-reflux anastomosis should be performed.