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目的:探讨常规手术与微创治疗输尿管狭窄临床疗效。方法:回顾性分析2012年2月~2012年12月我院收治14例输尿管狭窄患者的临床资料,女性患者6例男性患者8例,其中肾功能受损病例4例,行输尿管镜下钬激光碎石治疗术后狭窄7例,体外碎石治疗造成狭窄3例,误诊输尿管肿瘤2例,行子宫肌瘤血管栓塞输尿管狭窄1例、行子宫肌瘤切除损伤输尿管1例,不明原因1例。输尿管第2狭窄段狭窄病例9例,末端壁外端狭窄5例,输尿管狭窄段平均1.1cm,其中开放手术6例,球囊扩张9例,1例球囊扩张失败改为开放手术,双丁管留置时间为3~6个月,其中无法耐管1例2月后取管,14例病例均获得回访,回访时间6个月~15个月。结果:13例手术完成顺利、1例改为开放手术,输尿管肿瘤病例排除、术后病理为子宫内膜异位症,住院时间3~9天,平均5.8天,14例随访B超肾积水消失10例、轻度积水4例,CTU复查手术侧输尿管均通常。结论:球囊扩张手术与开放手术可以获得等同的临床疗效,住院时间缩短、痛苦较小、恢复快,费用低,可以选择性试行输尿管狭窄治疗。
Objective: To investigate the clinical effects of conventional surgery and minimally invasive treatment of ureteral stricture. Methods: The clinical data of 14 patients with ureteral stricture admitted to our hospital from February 2012 to December 2012 were retrospectively analyzed. Among the 6 female patients, 8 were male patients, of which 4 were renal dysfunction cases and were treated by ureteroscopic holmium laser Graft treatment of postoperative stenosis in 7 cases, 3 cases of in vitro lithotripsy caused by stenosis, misdiagnosis of ureteral tumor in 2 cases, uterine fibroids embolization ureter stenosis in 1 case, uterine fibroids resection injury ureter in 1 case, unknown cause in 1 case. Ureteral stenosis stenosis in 9 cases, 5 cases of distal wall stenosis, ureteral stricture average 1.1cm, of which 6 cases of open surgery, balloon dilatation in 9 cases, 1 case of balloon dilation failed to open surgery, double-Ding Tube indwelling time of 3 to 6 months, of which 1 case of non-resistant tubes after taking control 2 months, 14 cases were received a return visit time of 6 months to 15 months. Results: Thirteen cases were successfully completed and one case was operated on open surgery. The cases of ureteral tumors were excluded. The postoperative pathology was endometriosis. The length of hospital stay was 3-9 days (mean, 5.8 days). Fourteen cases were followed up for B - Disappeared in 10 cases, mild hydronephrosis in 4 cases, CTU review of surgical ureters are usually. Conclusions: Balloon dilatation and open surgery can achieve the same clinical curative effect, shorter hospitalization time, less pain, faster recovery and lower cost, and can selectively treat ureteral stricture.