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目的 探讨输尿管镜术 (URSL)失败的原因和相应的处理对策。方法 回顾性总结了 74侧输尿管镜术失败的临床资料 ,分析其失败的原因和相应的处理方法。结果 URSL失败的原因包括不能接近结石 46侧 ,处理结石困难 12侧 ,造成输尿管损伤15侧。失败后改行开放手术 44侧 ,治疗成功率 10 0 % ;改行ESWL 3 4侧 ,治疗成功率为 85 3 % ;仅 1例死亡。结论 输尿管镜术失败的原因包括不能接近结石、结石处理困难和输尿管损伤等。疗效与器械因素、术者因素和患者因素均有关。精良的设备、熟练的技巧和正确地选择病例是手术成功的关键。操作遇到困难应采取正确、及时的对策。失败后应根据情况改用ESWL或开放手术治疗。
Objective To investigate the causes of failure of ureteroscopy (URSL) and the corresponding treatment measures. Methods The clinical data of 74 cases of ureteroscopic failure were retrospectively reviewed, and the reasons for failure and the corresponding treatment methods were analyzed. Results The reasons for the failure of URSL included the inability to access the side of the stone 46, the side of the stone to handle difficulties 12, and the ureteral injury to the side 15. After the failure to divert 44 open surgery, the success rate of 10 0%; diverted ESWL 3 4 side, the success rate of 85 3%; only 1 case of death. Conclusions The causes of ureteroscopic failure include failure to access stones, difficulties with stone management, and ureteral injury. Efficacy and equipment factors, surgical factors and patient factors are related. Sophisticated equipment, skillful skills and the right choice of case are key to successful surgery. Operation difficulties should be taken to correct and timely countermeasures. After the failure should be changed to ESWL or open surgery treatment.