输尿管镜直视下球囊扩张治疗输尿管狭窄（附9例初步报告）

摘要： 探讨内镜下定位输尿管狭窄球囊扩张术应用的安全性和可行性。方法 该科2017年2月－2017年12月应用内镜下定位输尿管狭窄球囊扩张术的患者共9例，对其手术过程及结果进行回顾性分析。9例患者均为单侧狭窄，右侧5例，左侧4例，狭窄长度约0.50～1.00?cm，狭窄部位：上段6例，中段2例，下段1例；泌尿系超声、静脉肾盂造影（IVP）、逆行造影或CTU检查确诊。结果 全部手术顺利行顺行球囊扩张8例，逆行球囊扩张1例，手术时间（81.44±8.96） min，术后第3个月拔除双J管，随访时间4～10个月，行泌尿系B超和IVP检查，全部患者腰痛消失，7例积水减轻，2例未加重。结论 内镜下定位行输尿管狭窄球囊扩张术安全、有效，值得推广。
Abstract: To evaluate the feasibility, safety and efficacy of ureteral stricture treated by balloon dilatation in uretetoscope. Methods From February to December 2017, retrograde or anterograde balloon dilatation was performed in 9 cases of patients with ureteral strictures. Of the 9 patients, 4 had ureteral stricture on the left side and 5 on the right side. The length of stenosis was from 0.50?~?1.00 cm. There was 6 upper ureter stenosis, 2 middle part stenosis, 1 lower part stenosis. The diagnosis was established by renal ultrasonography, intravenous pyelogram (IVP) or/and computed tomography urography (CTU), retrograde urography imaging. Results Retrograde balloon dilatation was performed in 8 patients, and anterograde balloon dilatation was performed in 1 patient. The mean operative time of 9 cases was (81.44?±?8.96) min. With the follow-up of 4?~?10 months, ultrasonography and IVP were routinely performed. The Double J tube was removed 3 months post surgery. All the patients showed improved effect, the degree of hydronephrosis decreased in 7 cases, without aggravated in 2 cases. Conclusion Ureteral stricture treated by balloon dilatation in uretetoscope is safe and effective, which is worth of clinical promotion.