本文選題：輸尿管鏡　切入點：輸尿管口　出處：《中國微創(chuàng)外科雜志》2017年11期 　論文類型：期刊論文

【摘要】：目的總結(jié)輸尿管口進(jìn)鏡失敗后再處理的成功經(jīng)驗。方法 2013年6月~2016年5月輸尿管進(jìn)鏡失敗89例,再次輸尿管鏡進(jìn)鏡,成功處理輸尿管下段病變。結(jié)果 19例輸尿管口狹窄中,13例直接上鏡成功,4例鈥激光切開進(jìn)鏡,2例留置雙J管處理;23例輸尿管壁內(nèi)段走行異常形成假道中,均在假道外上方尋找到原輸尿管口,進(jìn)鏡成功;26例輸尿管口結(jié)石堵塞中,20例直接碎石后進(jìn)鏡成功,2例采用電切鏡切開輸尿管口再碎石,4例斑馬導(dǎo)絲把結(jié)石推上去后再碎石;21例輸尿管口尋找困難中,11例開口被突入膀胱的前列腺增生組織掩蓋,4例開口在多發(fā)的膀胱小梁內(nèi),膀胱慢性炎癥改變4例,2例異位輸尿管開口,均找尋成功進(jìn)鏡。結(jié)論輸尿管鏡術(shù)中出現(xiàn)進(jìn)鏡困難在所難免,術(shù)前應(yīng)對病情了解準(zhǔn)確,熟悉輸尿管的解剖結(jié)構(gòu)及輸尿管鏡下的立體空間感,熟悉各類輸尿管口進(jìn)鏡困難類型,有利于提高再處理成功率。
[Abstract]:Objective to summarize the successful experience of ureteroscopy after failure of ureteroscopy. Methods from June 2013 to May 2016, 89 cases of ureteroscopy failed and ureteroscopy was performed again. Results of the 19 cases of ureteral orifice stenosis, 13 cases were treated directly by endoscopy, 4 cases were treated by holmium laser incision, 2 cases were treated by double J tube, 23 cases were treated with double J tube, 23 cases formed false canal in the course of abnormal internal segment of ureter wall. The original ureteral orifice was found above the false passage. In 26 cases of obstruction of ureteral orifice stones, 20 cases were treated with direct lithotripsy and 2 cases were treated with electrosurgical incision of ureteral orifice and relithotomy of ureteral orifice. 4 cases were treated with zebra guide wire to push the stone up and 21 cases with difficulty in finding ureteral orifice. 11 cases had difficulty in finding ureteral orifice. In 4 cases, the opening was covered by protruding prostate hyperplasia tissue into the bladder, and the opening was in the multiple trabeculae of the bladder. There were 4 cases of chronic inflammation of bladder and 2 cases of ectopic ureteral orifice. It is helpful to improve the success rate of reprocessing by knowing the anatomical structure of ureter and the sense of three-dimensional space under ureteroscope and the difficult types of ureteral orifice.
【作者單位】： 湘潭市中心醫(yī)院泌尿外科;
【分類號】：R699.4

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