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目的:探讨输尿管镜联合钬激光治疗输尿管狭窄的疗效。方法:对31例输尿管狭窄患者采用输尿管硬镜扩张或联合钬激光行内切开术治疗,术后留置1根或2根F5双J支架管,2～3个月后拔管。结果:31例病人中,3例发生输尿管穿孔,5例失败。中转开放手术3例,2例改经皮肾穿顺行治疗。26例手术成功病人中,硬性扩张成功10例,钬激光治疗成功16例;术后均有不同程度血尿,3例术后发生感染,经抗炎治疗后治愈。无邻近重要脏器损伤,无大出血、尿瘘等严重并发症,术后2～3个月拔除双J管,随访6～12个月,痊愈20例(64.5%),好转6例(19.4%),无效5例(16.1%)。结论:输尿管镜联合钬激光治疗输尿管狭窄是一种安全、有效的微创手术方法。
Objective: To investigate the efficacy of ureteroscope combined with holmium laser in the treatment of ureteral stricture. Methods: Thirty - one patients with ureteral stricture underwent ureteral dilatation or combined holmium laser underwent endotracheal incision. One or two F5 double - J stent tubes were placed after operation and extubated after 2 to 3 months. Results: Among the 31 patients, ureter perforation occurred in 3 cases and failed in 5 cases. 3 cases of open surgery, 2 cases of percutaneous renal bypass therapy. In 26 cases of successful operation, 10 cases were successfully dilated hard and 16 cases were successfully treated with holmium laser. All patients had hematuria after operation and 3 cases had postoperative infection and were cured after anti-inflammatory treatment. There was no serious injury of adjacent organs, no serious hemorrhage, urinary fistula and other serious complications. The double J tube was removed 2 to 3 months after operation, followed up for 6 to 12 months. 20 cases (64.5%) recovered, 6 cases improved (19.4%), , Invalid in 5 cases (16.1%). Conclusion: Ureteroscopy and holmium laser treatment of ureteral stricture is a safe and effective minimally invasive surgery.