【摘要】 目的 评估透视下顺行钳夹活检诊断输尿管回肠代膀胱吻合口狭窄的可行性。方法 选取接受Bricker术出现集合系统积水的患者22例，应用导管导丝技术，经皮经肾通路开通输尿管回肠代膀胱狭窄区，建立鞘管活检通道。对输尿管回肠代膀胱吻合口行钳夹活检，术后置入10.2F输尿管支架。记录技术成功率、并发症、活检敏感度、特异度、准确性，并比较术前与术后白细胞计数、肌酐、尿素氮水平。结果 技术成功率100%（22/22）,且未出现输尿管穿孔、大出血等严重并发症。活检准确率为95.45%（21/22）,敏感度为85.71%（6/7）,特异度为100%（15/15）。术前、术后白细胞计数为（9.17±2.16）×10¹²/L vs （6.03±1.51）×10¹²/L;术前、术后肌酐水平为（219.95±78.47） U/mL vs （78.91±17.23）U/mL;而术前、术后尿素氮水平为（19.85±5.27） U/mL vs （5.95±1.60） U/mL,3项指标均有统计学差异（P<0.05）。结论 透视下顺行钳夹活检诊断输尿管回肠代膀胱吻合口狭窄方案安全可行。更多还原

【Abstract】 Objective To evaluate the feasibility of fluoroscopy-guided anterograde forceps biopsy for diagnosing uretero-ileal neobladder anastomotic stenosis.Methods Twenty-two patients who underwent Bricker surgery presented with hydronephrosis were selected.Using a catheter-wire technique,percutaneous nephrostomy tract was used to access the uretero-ileal neobladder stricture and establish a sheath biopsy channel.Forceps biopsy was performed at the uretero-ileal neobladder anastomotic site,followed by placement of a 10.2F ureteral stent.The technical success rate,complications,biopsy sensitivity,specificity,accuracy were recorded,and preoperative versus postoperative white blood cell counts,creatinine,and urea nitrogen levels were compared.Results The technical success rate was 100%（22/22）,with no serious complications,such as ureteral perforation and major bleeding.The accuracy,sensitivity and specificity of the biopsy were 95.45%（21/22）,85.71 %（6/7）and 100%（15/15）,respectively.Preoperative and postoperative white blood cell counts were（9.17±2.16） ×10¹²/L vs（6.03±1.51） × 10¹²/L,creatinine levels were（219.95±78.47） U/mL vs（78.91±17.23） U/mL,and urea nitrogen levels were（19.85±5.27） U/mL vs（5.95±1.60） U/mL.All three parameters showed statistically significant differences（P<0.05）.Conclusion The fluoroscopyguided anterograde forceps biopsy for diagnosing uretero-ileal neobladder anastomotic stenosis is safe and feasible.更多还原