摘要
目的探讨双根D-J管联合球囊扩张术在治疗良性输尿管狭窄的疗效,分析其安全性及有效性。方法通过回顾分析本单位12例良性输尿管狭窄围手术期患者及随访相关资料。所有患者诊断为良性输尿管狭窄,患侧输尿管接受了巴德球囊扩张术,放置两根4.8F输尿管内支架管,留置时间为3个月。取出支架后行输尿管镜检术评估输尿管狭窄情况及此后第1、3、6个月复查泌尿系B超明确积水有无较前加重。结果12例患者中男性8名,女性4名,平均年龄为36.3±10.9岁。其中左侧输尿管狭窄7例,右侧输尿管狭窄5例。上段输尿管狭窄3例,中段输尿管狭窄7例,下段输尿管狭窄2例。输尿管狭窄平均长度为1.19±0.47cm。12例患者均于置管后3个月拨管,经镜检未见明显狭窄,所有患者在取除内支架管后第1个月未出现肾积水加重。1例患者在取除内支架管后第3个月出现肾积水轻度加重。2例患者在取除内支架管后第6个月出现肾积水轻度加重,第1例复发患者肾积水较第1个月增加0.8 cm。第2和第3例患者(新增)较第3个月肾积水增加分别为0.3 cm和0.4 cm。结论对于良性输尿管狭窄,双根"D-J"管置入可使得引流更通畅,可有效防止输尿管狭窄扩张术后的再次复发。
Objective To investigate the efficacy of double D-J stents combined with balloon dilatation in the treatment of benign ureteral stricture,and to analyze its safety and effectiveness.Methods A retrospective analysis of 12 patients with benign ureteral stricture perioperative period and follow-up related data.All patients were diagnosed with benign ureteral stricture,and the affected ureter received balloon dilation.Two 4.8 F ureteral stents were placed with the indwelling time of 3 months.After the stents were removed,the ureteral stricture was evaluated by ureteroscopy.At 1 st,3 rd,and 6 th month after stents removed,the ultrasound was used to assess the degree of hydronephrosis.Results Eight were male and 4 were female of the 12 patients,with an average age of 36.3±10.9 years.There were7 cases of left ureteral stricture and 5 cases of right ureteral stricture.There were 3 cases of upper ureteral stricture,7 cases of middle ureteral stricture and 2 cases of lower ureteral stricture.The average length of the ureteral stricture was 1.19±0.47 cm.All the stents of twelve patients were removed 3 months after stents insertion.No obvious stricture was observed by urterscopy.All patients showed no increase in hydronephrosis in the first month after the removal of the stents.One patient developed mild hypertrophy in the third month after removal of the stents.In 2 patients,the hydronephrosis was slightly aggravated at the 6 th month after removal of the endodontic tube.In the first case,the recurrent hydronephrosis was increased by 0.8 cm compared with the first month.The second and third patients(new case)had an increase in hydronephrosis of 0.3/0.4 cm compared with the third month.Conclusion For benign ureteral stricture,double"D-J"tube placement can make drainage more patency,and can effectively prevent recurrence after ureteral stricture.
作者
张育周
张俊鑫
徐煜宇
陈双星
徐桂彬
ZHANG Yu-zhou;ZHANG Jun-xin;XU Yu-yu;CHEN Shuang-xing;XU Gui-bin(Department of Urology,Puning Overseas Chinese Hospital,515300,China;Department of Urology,The Fifth Hospital Affiliated to Guangzhou Medical University,510700,China)
出处
《岭南现代临床外科》
2021年第3期345-348,共4页
Lingnan Modern Clinics in Surgery
基金
广东省自然科学基金(2018A030313087)。
关键词
良性输尿管狭窄
双根D-J管
疗效分析
benign ureteral stricture
double root D-J stents
therapeutic effect
