【摘要】 目的分析影响输尿管镜下逆行球囊扩张术治疗良性输尿管狭窄(US)预后的相关因素。方法回顾性分析我科2012年10月至2016年10月期间行输尿管镜逆行球囊扩张术治疗的单侧单发的良性输尿管狭窄患者临床资料,总共40例患者,其中男、女各20例,年龄25～76岁,输尿管狭窄段位置位于盂管交界处12例,输尿管上段8例,中段3例,下段17例。输尿管狭窄段的长度0.2～2 cm。均应用U30球囊扩张器扩张,所有患者术后常规留置双J管或者海马管6个月至1年,每3个月更换一次,术后随访1年。结果手术时间45～90 min,平均60 min。术后2～3 d出院,平均住院日2.5 d,无严重并发症,血尿及尿路刺激征并发症发生率较高,术后随访1年,有效患者25例(62.5%),无效患者15例(37.5%)。单因素χ~2检验及多因素Logistic回归分析显示输尿管狭窄段的长度及术前患侧肾积水程度是影响输尿管镜球囊扩张术预后的主要因素(P<0.05),而患者的性别、年龄及输尿管狭窄的位置以及狭窄的原因对手术治疗预后无显著影响(P>0.05)。结论输尿管镜下逆行球囊扩张术是治疗良性输尿管狭窄安全、有效的手术方法。更多还原

【Abstract】 Objective To analyze the factors influencing the prognosis of benign ureteral stricture which treated by retrograde balloon dilatation in ureteroscopy. Methods Forty patients with benign unilateral ureteral stricture who underwent retrograde ureteral balloon dilatation from October2012 to October 2016 in our department were retrospectively reviewed. Age ranged from 25 to 76 years old. Twelve cases whose ureter stenosis located at the junction of the renal pelvis, 8 cases at the upper ureter, 3 cases at the middle and 17 cases at the lower part. The length of the ureteral stricture was between 0.2 cm and 2 cm. All patients were treated with U30 ureteroscopic balloon dilation catheter,and double J stent or hippocampus ureteral stent was implanted for 6 months to 1 year after operation.The stent was replaced every 3 months and all patients were followed up for one year postoperatively.Result The operation time was between 45-90 min, with an average of 60 min. Patients spent an average of 2.5 days in the hospital after operation. There was no severe complication occurred, and the most common type of complications were hematuria and urinary tract irritation. During one year postoperative follow up, 25 patients(62.5%) were successfully treated with ureteral stricture and 15 cases(37.5%) of treatment failure were observed. Univariate Chi-square test and multivariate logistic regression analysis showed that length of ureteral stricture and degree of hydronephrosis were the main factors affecting the prognosis of surgery(P<0.05), whereas gender, age, location of ureteral stricture and causes of the stenosis had no statistical significance(P>0.05). Conclusion Ureteroscopic balloon dilatation is a safe and effective surgical treatment for benign ureteral stricture.更多还原