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目的探讨输尿管镜治疗输尿管结石致输尿管损伤的原因以及防治措施。方法选取2011年4月—2013年3月在峡江县人民医院接受输尿管结石治疗的324例输尿管结石患者,其中11例患者采用输尿管镜进行气压弹道治疗时出现输尿管损伤,对11例患者的临床资料进行回顾性分析,总结其采用输尿管镜治疗导致输尿管损伤的原因及防治措施。结果 324例患者输尿管损伤的发生率为3.39%,11例患者中9例患者为输尿管穿孔,占2.78%,其中输尿管中段结石为7例,2例患者为输尿管下段及末端结石;8例患者手术过程中给予双J管留置术,1例患者采用腹腔镜下输尿管切开取石术。1例患者出现输尿管黏膜下假道,占0.31%,术中采用双J管留置术;1例患者输尿管黏膜不完全撕脱,占0.31%,予手术处理。结论输尿管镜手术是常见的治疗输尿管结石的外科手术方式,手术安全性高,但术中可变性强,因此需要采用正确的操作手法,避免损伤输尿管。
Objective To investigate the causes of ureteroscopic ureteroscopic ureteral injury and its prevention and treatment. Methods A total of 324 patients with ureteral calculi undergoing ureteral calculi in Xiajiang County People’s Hospital from April 2011 to March 2013 were selected. Eleven patients underwent ureteroscopic pneumatic ballistic surgery for ureteral injury and 11 patients were clinically Data were retrospectively analyzed, summarizes the reasons for ureteroscopic treatment of ureteral injury and prevention and treatment measures. Results The incidence of ureteral injury in 324 patients was 3.39%. Among the 11 patients, 9 patients were ureter perforation (2.78%). The middle ureteral calculi was 7 cases, 2 cases were the lower ureter and the end of the stone. 8 cases were operated on Double J catheter indwelling surgery, 1 case of laparoscopic ureterolithotomy. 1 patient had submucosal ureter, accounting for 0.31%, double J tube indwelling intraoperative; 1 patient ureteral mucosa incomplete avulsion, accounting for 0.31%, to be surgically treated. Conclusion Ureteroscopic surgery is a common surgical treatment of ureteral calculi, surgical safety, but intraoperative variability and therefore need to use the correct operation practices to avoid damage to the ureter.