【摘要】 目的探讨经尿道输尿管镜钬激光肾盂内切开术治疗肾盂输尿管连接部狭窄的效果。方法2002年4月～2004年9月期间,经尿道输尿管镜下行肾盂内切开治疗成人型肾盂输尿管连接部狭窄30例。狭窄段纵行切开后,输尿管内放置8F双J管内引流,平均留置双J管6周,每间隔3个月行超声、排泄性尿路造影检查。结果术后随访3～22个月,平均18个月,22例临床症状缓解,影像学检查提示内切开段造影剂通过良好,治疗成功;8例手术失败,均为巨大肾盂积水患者,改行Aderson-Hynes离断性肾盂成形术治愈。结论经尿道输尿管镜下钬激光肾盂内切开术创伤小、安全有效,可做为轻中度肾盂积水肾盂输尿管连接部狭窄患者治疗的首选方法。更多还原

【Abstract】 [Objective] To evaluate the therapeutic effect of retrograde ureteroscopic Ho:YAG laser endopyelotomy for correction of ureteropelvic junction (UPJ) obstruction. [Methods] From 2002.4～2004.9, retrograde ureteroscopic Ho:YAG laser endopyelotomy was carried out on 30 adult patients of UPJ obstruction. The obstruction was incised with a 200 microm holmium laser fiber in a linear fasion. After completing incision, a french-8 double-J ureteral stent was left for 6 weeks. Thereafter, patients were monitored with excretory urography, B-ultrasound at 3 months regular intervals. Success was defined as symptomatic relief and radiographic resolution. [Result] Success was achieved in 22 cases without complication in- or post-operation at average follow up for 18 months(3～22 months). However, 8 cases of severe hydronephrosis were ineffective. [Conclusions] This procedure should be used initially for the treatment of some patients suffering from UPJ obstruction, because it is less invasive and effective.更多还原