【摘要】 目的分析经尿道输尿管镜球囊扩张与腔内钬激光内切开术治疗输尿管狭窄(US)的临床疗效。方法 64例US患者采用随机数字表法分为观察组、对照组各32例,对照组单纯予以腔内钬激光内切开术治疗,观察组采用经尿道输尿管镜球囊扩张联合腔内钬激光内切开术治疗,记录两组治疗有效率、围术期指标、输尿管狭窄程度及并发症发生率。结果观察组治疗有效率高于对照组(P <0. 05);观察组手术时间、术中出血量较对照组延长/增多,术后输尿管扩张时间短于对照组,再手术率较对照组低(P <0. 05),观察组住院费用高于对照组(P <0. 05);观察组术后输尿管狭窄段增宽程度高于对照组,而狭窄近端输尿管扩张程度低于对照组(P <0. 05);观察组术后6个月内并发症发生率低于对照组(P <0. 05)。结论经尿道输尿管镜球囊扩张与腔内钬激光内切开术治疗US有较好临床疗效,可明显缩短术后输尿管扩张时间,降低再手术率和输尿管狭窄程度,减少并发症风险,值得在临床推广实践。更多还原

【Abstract】 Objective To analyze the clinical curative effect of transurethral ureteroscopic balloon dilatation and intracavitary holmium laser incision in the treatment of ureteral stricture( US). Methods Sixty-four US patients were divided into observation or control group by using random number table method,32 in each group.The control group was treated with intracavitary holmium laser incision alone while the observation group was treated with transurethral ureteroscopic balloon dilatation and intracavitary holmium laser incision.The response rate,perioperative indexes,degree of ureteral stricture and the incidence of complications were recorded.Results The response rate of the observation group was higher than that of the control group( P < 0. 05).The operation time and intraoperative blood loss of the observation group were longer or more than those of the control group and the time for postoperative urethral dilation was shorter and the re-operation rate was lower than the control group( P < 0. 05).The hospitalization expenses of the observation group was higher than that of the control group( P < 0. 05).The widening degree of ureteral stricture was greater in the observation group than that in the control group,while the proximal ureteral dilatation was smaller than the control group after operation( P < 0. 05).The incidence of complications in the observation group within 6 months after operation was lower than that in the control group( P < 0. 05).Conclusion Combination of transurethral ureteroscopic balloon dilatation and intracavitary holmium laser incision are effective in the treatment of US.It can significantly shorten the time for postoperative urethral dilation,and reduce the reoperation rate,degree of ureteral stricture and the risk of complications.更多还原