【摘要】 目的总结硬性输尿管镜术中入镜困难的处理经验。方法1995年1月至2004年11月,应用F8/9.8输尿管硬镜逆行治疗640例输尿管结石。72例入镜困难,通过控制液压灌注泵压力、改变病人体位、扩张输尿管、肾穿刺造瘘等方法处理。结果72例入镜困难中成功54例,18例改开放手术。术中出现并发症16例,10例黏膜部分撕裂,6例输尿管穿孔。结论熟悉输尿管的解剖与病理生理特点,以及手术者的优良操作技巧及经验是入镜成功的关键。更多还原

【Abstract】 Objective To summarized the experience of management of difficult access during transurethral rigid ureteroscopy. Methods From January 1995 to November 2004,transurethral rigid ureteroscopy was used for the treatment of ureteral stones in 640 cases.Among them,72cases were difficult access. Results through controlling the hydraulic irrigation,changing the patient’s position,dilation of the ureter or percutaneous nephrostomy ,54 of 74 cases were successful access of rigid ureteroscope.Ureterolithotomy (open surgery) was needed only in 18 cases.The postoperative complications were occurred in 16 cases,including partial mucosal laceration in 10 cases and ureterral perforation in 6 cases.Conclusion Knowing the feature of ureteral anatomy and patho physiology,operator’s excellent skill and operative experience are keys to successful access of rigid ureteroscope.更多还原