论文部分内容阅读
目的:分析输尿管硬镜钬激光治疗输尿管结石的失败或并发症发生原因,探讨其防治对策。方法:我院2010年6月~2012年6月间行输尿管硬镜钬激光碎石术治疗输尿管结石而发生输尿管内碎石失败及术中术后并发症者57例,结合文献复习对其发生原因进行回顾性分析。结果:8例因输尿管狭窄在上镜过程中发生输尿管穿孔致碎石失败,14例因输尿管上段扩张结石移位进入肾内致碎石失败,11例出现输尿管壁损伤出血致碎石失败,17例因输尿管迂曲未能到达结石部位而进输尿管镜失败,1例术中发生输尿管黏膜撕脱,6例术后出现不同程度发热。结论:输尿管硬镜钬激光碎石术常出现出血、穿孔、结石移位残留、感染等并发症,并有可能导致手术失败。临床上应重视这些问题并研究相应的处理对策,熟练的技术操作及严格掌握适应证是减少并发症和降低手术失败率的关键。
OBJECTIVE: To analyze the causes of the failure or complications of ureteroscopic holmium laser for the treatment of ureteral calculi, and to discuss its prevention and treatment measures. Methods: From June 2010 to June 2012, 57 cases underwent ureteroscopic holmium laser lithotripsy for the treatment of ureteral calculi and failure of ureteral lithotripsy and intraoperative and postoperative complications were reviewed. Reasons for retrospective analysis. Results: In 8 cases ureteral perforation caused by ureteral stricture failed, lithotripsy of 14 cases due to dilatation of ureteral dilatation stones failed to enter the kidney, 11 cases failed ureter wall injury due to hemorrhage, and 17 cases failed Ureteroscopy failed because ureter tortuosity failed to reach the site of the ureter, 1 case had ureteral mucosal avulsion and 6 had postoperative fever of varying degrees. CONCLUSIONS: Ureteroscopic holmium laser lithotripsy often causes complications such as bleeding, perforation, residual residual stones and infection, which may lead to the failure of surgery. Clinical should pay attention to these problems and to study the appropriate treatment strategies, skilled technical operation and strict indications is to reduce the risk of complications and reduce the failure rate of the key.