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目的:研究膀胱瓣输尿管吻合术处理输尿管硬镜导致的输尿管撕脱的疗效。方法:回顾我院完成输尿管硬镜下钬激光碎石378例,期间术中发生输尿管镜致输尿管撕脱2例,均行膀胱瓣输尿管吻合术处理输尿管撕脱。结果:2例患者随访6个月以上,随访无特殊情况,患侧肾功能均正常。结论:避免输尿管镜下并发症应选择好麻醉方式;进镜时应使用斑马导丝引导下进入;在上镜过程中突感突破感,上镜容易,退镜难,退镜时镜头可见黏膜逐渐平坦且视野不退缩,要高度警惕输尿管下端撕脱。发生输尿管镜下撕脱时应根据撕脱长度及撕脱位置选择合适的输尿管缺损段替代手术方案。
Objective: To study the curative effect of ureteral anastomosis treated with ureteroscopic ureteral avulsion caused by ureteroscope. Methods: A retrospective study of 378 cases of ureteroscopic holmium laser lithotripsy in our hospital during ureteroscopic ureteral avulsion occurred in 2 cases, both treated with ureteral anastomosis bladder flap avulsion. Results: Two patients were followed up for more than 6 months, no special circumstances were followed up, the ipsilateral renal function were normal. Conclusion: To avoid the complications of ureter should choose a good anesthesia method; into the mirror should be guided into the use of zebra guide wire; in the process of imaging sudden sense of breakthrough, the mirror is easy to retreat mirror difficult to retreat when the lens visible mucosa gradually flat And vision does not flinch, to be highly vigilant ureteral avulsion. In the event of ureteroscopic avulsion should be based on avulsion length and avulsion position to select the appropriate ureteral defect replacement surgical options.