输尿管镜术中困难和并发症的原因与处理

目的:探讨输尿管镜术中困难和并发症的原因及处理.方法:回顾性分析2008-03~2011-03行输尿管镜手术300例患者临床资料.结果:300例患者中,术中困难37例,中转开放手术11例.结石上移8例.转开放手术的原因为:入镜失败4例;上镜困难(未达到病变部位)6例,输尿管穿破1例.结论:输尿管镜术中困难和并发症与操作者的经验密切相关,掌握手术适应症,术前加强培训,熟练操作技巧,是减少失败率和并发症的关键.

The Difficulties and Complication of Ureteroscopy and the Mangement Strategies

Objective：To analysis the difficulties and complications emerged during transurethral ureteroscopy and offer their management strategies.Methods：A total 300patients accepting rigid transuretheal ureteroscopy from May 2008 to May 2011,were evaluated retrospectively.Results：Among 300 cases,37cases were found difficulties diring transurethral ureteroscopy,11cases were converted to open surgrey.stones shifted to renal pelvis in 8 patients.The causes of conversion to open include： ureteroscopy failed to enter ureteral oeific in 4 patient,ureteroscopy failed to get to the ill place in 6 patients,ureter perforation occurred in 1 patients.Conclusions：There are more difficulties and complications during ureteroscopy at early stage.Strictly mastering surgical indications.strengthening preoperative training,mastering the surgical technique is the key to reduce the failure rate and complications of ureteroscopy.