输尿管硬镜上镜困难原因分析及处理

目的总结和评价输尿管镜手术时上镜困难的原因及其对策。方法分析了2002年10月～2005年6月收治的326例次输尿管镜手术患者的临床资料。结果24例上镜困难者，10例是采用技巧性的旋转及其变换角度才能入镜，14例有不同程度的狭窄或迂曲，经扩张或调整体位后有12例成功，1例中转开放，1例插管碎石。结论输尿管上镜困难并不少见，熟悉输尿管解剖与技巧性操作可提高取石率。

Analysis of cause of difficult access during rigid transurethral ureteroscopy and management

[Objective] To analyse the cause of diffcult access during rigid transurethral ureteroscopy and how to manage that case. [Methods] From Oct 2002 to Jun 2005, 326 cases of rigid transurethral ureteroscopy were evaluated retrospectively. [Results] 24 of 326 cases were difficult to perform ureteroscopy, but 10 of 24 cases could be successfully to achieved with skill. 12 of 14 cases with ureter stricture or flexura were rendered to dilate satisfactlly, but for the other two, one tranfer to operation, and one ESWL with ureter catheter. [Conclusions] Difficult access to ureter is not rare. We should be familiar with the anatomy of ureter and master the techniques of operation.