球囊扩张术治疗继发性输尿管狭窄疗效分析

目的探讨输尿管镜直视下球囊扩张术治疗继发性输尿管狭窄的效果。方法以在西京医院就诊的85例继发性输尿管狭窄患者作为研究对象,根据其治疗方法将其分为重复扩张组(球囊扩张时间为3min,扩张次数为2次)、单次扩张组(球囊扩张时间为5min,扩张次数为1次)和对照组(仅留置双J管),分析输尿管镜直视下球囊扩张术治疗继发性输尿管狭窄的效果差异。结果共纳入85例患者,其中重复扩张组32人,有效率84.38%;单次扩张组29人,有效率62.07%;对照组24人,有效率25.00%。各组的手术时间较短,出血量极少,3组患者术后并发症发生率无差别,且均未出现严重的并发症,其中狭窄段>2cm的患者扩张的成功率(47.06%)远低于狭窄段≤2cm(84.09%)的患者。结论输尿管镜直视下球囊扩张术是治疗继发性输尿管狭窄的有效方式;同等气压条件下适当缩短扩张时间,增加扩张次数,可提高治疗有效率;狭窄段长度影响扩张的效果。

Efficacy of balloon dilatation in the treatment of secondary ureteral stricture

Objective To investigate the efficacy of balloon dilation under ureteroscope in the treatment of secondary ureteral stricture.Methods Patients with secondary ureteral stricture treated at Xijing Hospital were involved.According to the treatment methods,the patients were divided into repeated dilatation group(balloon expansion time 3 minutes,dilatation twice),single dilatation group(balloon dilatation time 5 minutes,dilatation once) and control group(only double J tube indwelt).The efficacy of the 3 groups was analyzed.Results A total of 85 patients were enrolled,including 32 in the repeated dilatation group,29 in the single dilatation group,and 24 in the control group.The effective rate was 84.38% in the repeated dilatation group,62.07% in the single dilatation group,and 25.0% in the control group.The operation time was short in all groups,the amount of bleeding was small,no serious postoperative complications occurred,and there were no statistical differences among the three groups.The success rate of dilatation in patients with>2 cm stenosis was much lower than that in patients with≤2 cm stenosis(47.06% vs.84.09%).Conclusion Balloon dilatation under ureteroscope is an effective way to treat secondary ureteral stricture.It can shorten the dilatation time,increase the number of dilatation under the same atmospheric condition,and improve the treatment efficacy.The segment length affects the efficacy of dilatation.