摘要
[目的]探讨输尿管镜联合肾筋膜扩张器在女性输尿管下段狭窄并结石治疗中的效果.[方法]6例女性输尿管狭窄患者于硬膜外麻醉下用F8/9输尿管镜经尿道、膀胱及输尿管口置入输尿管,检查输尿管狭窄情况,直视下将斑马导丝通过狭窄段输尿管置入肾盂,退镜保留导丝,在导丝引导下将肾筋膜扩张器从F8开始依次递增扩张输尿管到F16,每次扩张5 min,拔出F16肾筋膜扩张器,重新置入输尿管镜通过狭窄部输尿管,气压弹道将结石击碎,取石钳将碎结石取出,沿斑马导丝置入F7 D-J管做支架内引流,F18双腔导尿管留置导尿.[结果]本组6例患者5d后拔尿管出院,2个月后拔除D-J管,拔管后腰痛症状消失,术后6个月复查B超肾积水较术前均明显改善.[结论]输尿管镜联合肾筋膜扩张器治疗女性输尿管下段狭窄并结石具有操作简单、安全、实用、复发率低等特点,值得临床上推广使用.
[Objective] To explore the clinical application of ureteroseope plus renal fascia dilator in the treatment of female low ureter stricture with stone. [Methods]Six female patients with ureteral stricture were placed with the ureter by using F8/ 9 ureteroscope via urethra, bladder and ureteric orifice to examine the ureter stricture under spinal anesthesia. Zebra guidewire was placed into kidney pelvis via stenosis ureter, and then retained after the withdrawal of ureteroscope. Renal fascia dilator was inserted serially to dilate the ureter from F8 to F16 guided by the wire. The dilation time was 5rain once. After F16 renal fascia dilator was drawn, ureteroscope was placed again via stenosis ureter. Ureterstone was treated with pneumatic litho- tripter. The broken stone was drawn by using the forceps. F7 D-J stent was placed along zebra guidewire for the drainage. F18 double catheter was detained. [Results] All 6 patients discharged from hospital 6 days after the removal of the catheter. D-J stent was drawn after 2 months. The symptoms of low back pain disappeared after the removal of the catheter. P-ultra- sound examination 6 months after operation showed that hydronephrosis was improved obviously compared with that before operation. [Conclusion]Ureteroscope plus renal fascia dilator for the treatment of female low ureter stricture with stone has ad- vantages such as simplicity, safety, practice and low recurrence rate, etc. Therefore, it is worthy of clinical promotion and ap- plicatio.
出处
《医学临床研究》
CAS
2012年第1期71-72,共2页
Journal of Clinical Research
