球囊扩张术治疗输尿管狭窄的疗效分析

球囊扩张术治疗输尿管狭窄的疗效分析

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电切加球囊扩张术治疗输尿管狭窄的

疗效分析

贾占奎陈瑞廷金志波胡宝利杨锦建

I摘要】目的探讨输尿管镜下电切加球囊扩张术治疗输尿管狭窄的临床疗效。方法回

顾性分析2008年6月至2011年6月收治的49例输尿管狭窄患者的lI缶床资料.其中,男20例,女

29例。年龄15—56岁,平均40岁。患侧肾功能轻度受损者4例,中度受损者35例,重度受损者

10例。肾盂输尿管连接处狭窄1l例.输尿管上段狭窄13铡。中下段狭窄25例。狭窄段长度0.3—

2.0cm。平均为1.2cm。其中经皮肾微穿刺输尿管镜下电切加球囊扩张术治疗17倒,经尿道输尿管

镜下完成31例。双J管留置3—6个月,45例患者获随访,随访时间12—43个月,平均24个月。

结果48例手术顺利完成,I例中转开放行肾五输尿管连接部成形术。手术时问25—95rain,平均

42rain;术后住院时间2—6d,平均4d。45例随访复查B超及cT示肾积水明显减轻39例,IVU示输

尿管显影通畅无明显狭窄;肾积水无明显变化6例。结论输尿管镜直视下电切结合球囊扩张治

疗输管狭窄手术效果确切、痛苦小、术后恢复快、住院时间短,为输尿管狭窄患者提供新的有效治疗

方法。

【关键词】输尿管狭窄;输尿管镜; 电切加球囊扩张术; 回顾性研究

Efficacy analysis of transnrethral resection and ball pouch dilatation for treatment af ureterastenosis

JIA Zhan.kui,CHEN Rut—tins,J/N Zhi-be,HU Bao—li,YANG fin-jian.D印anmem ofUrology,First Vfiti-

ated Hospital of Zhengzhoa University,Zhengzhoa 450052,China

Corresponding author:YANG Jin-

fian,Email:**********************

【Abstract】Objective To investigate the efficacy of transurethral resection and ball pouch dilatation

for treatment of oreterosteansis. Methods The clinical data of

49cases of ureteral stricture were analyzed

retrospective analysis from June 2008to June 2011with 20caseB of mah patients and 29cases of female pa-

tients.The age Wag 15to 56years。with a mean age

of40years.1psilateral renal function were mild impai’

ment in 4eases,moderate impairment in 35eases,and severe damage in 10cases.There were ureteropelvic

junction stenosis in 1l cases-upper ureteral stricture in 13cases。and lower segment stenosis in 25eases.

The ureteral stricture length wa30.3IO 2.0cm.with a mean of

1.2CUl.Seventeen patients were treated

with transurethral resection and ball pouch dilatation by minimally invasive pereutaneous nephrostomy,and

31oaaes were completed by ureteroscopy.The ureteral stents were removed by ureteruscope aftec 3—6

months.45eases were followed up for I 2—43months,with a mean of

24months. Results Forty—eiSht

cases were completed smoothly with 1ease converted to open

surgery.The SUrgicol time was 25to 95min

with a mean of 42rain.The postoperative hospital stay was 2to 6d with a mean of 4d.In the foUow—up of

45cas∞.B ultrasound and CT scan showed hydronephruais reduced significantly in 39patients,IVU showed

unobstructed ureter without significant stenosis.And 6cases showed no significant changes in hydronephro一

8i8.Conclusion The method of transurethral resection and ball pouch dilatation has good clinical effect.

1ess pain and shorter hospital stays,which provides a fleW and effective treatment for patients with ureteral

stricture.

【Key wards】 Ureterostenesis; Ureterescope;Transurethral resection and bail pouch dilatation;

DOI:tO.3760/cma.i-issn.1000-6702.2012.05.006