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目的探讨输尿管镜手术时进镜困难的原因与处理对策。方法回顾性分析115例输尿管镜手术患者中19例进镜困难者的临床资料,通过控制灌注泵压力、改变患者体位、扩张输尿管等方法处理。结果本组19例患者,成功进镜17例,失败2例。并发症均为术中发生,其中输尿管黏膜部分剥脱1例,输尿管穿孔3例,输尿管假道2例,6例患者均在放置输尿管内支架管充分引流后痊愈,无其他严重并发症发生。结论术前充分的了解输尿管的情况,熟悉输尿管的解剖和熟练掌握输尿管镜的操作技巧对克服术中输尿管进镜困难有重要意义。
Objective To investigate the causes of ureteroscopic surgery difficult to enter the mirror and treatment strategies. Methods A retrospective analysis of 115 cases of ureteroscopic surgery in 19 cases of patients with difficult to enter the clinical data by controlling the perfusion pump pressure to change the position of the patient to expand the ureter and other methods. Results 19 patients in this group, 17 cases successfully entered the mirror, two cases failed. Complications were all occurred intraoperatively, including partial exfoliation of the ureter mucosa in 1 case, ureter perforation in 3 cases, ureteral falsehood in 2 cases, and 6 cases of ureteral stent placed in full drainage after drainage healed without other serious complications. Conclusion Preoperative understanding of the ureter situation, familiar with the ureter anatomy and proficiency in ureteroscopic skills to overcome the intraoperative ureteroscopic difficulties are important.