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find Keyword "输尿管镜" 16 results
  • Clinical Application of Ureteroscope in Manipulation of Urological Diseases (Report of 1333 Cases)

    目的:探讨输尿管镜技术在泌尿外科疾病诊治中的临床应用价值。方法: 2002年9月至2008年9月应用经尿道输尿管镜技术诊断和治疗泌尿系疾病患者1333例。其中行输尿管镜治疗者1200例, 包括输尿管结石1010例,其中上段结石146例、中段344例、下段520例;输尿管狭窄18例;医源性双J管滞留38例;男性尿道狭窄38例;膀胱尿道结石41例;肾盂结石8例;输尿管阴道漏5例;小儿逆行输尿管插管20例;内支架管置入22例。其中用于诊断的患者133例。结果:治疗1010例输尿管结石,成功865例,成功率为85.6%,其中治疗输尿管上、中、下段结石的成功率分别为68.5%、81.7%及93.1%;输尿管狭窄、尿道狭窄、膀胱尿道结石、输尿管阴道漏及小儿逆行输尿管插管均疗效满意。用于诊断的133例患者中,发现肿瘤4例,阴性结石48例,息肉8例,输尿管结核9例,输尿管狭窄30例,无阳性发现34例。手术失败24例。发生严重手术并发症37例,其中死亡1例,感染性休克2例,黏膜撕脱4例,穿孔15例、假道12例,严重出血3例。结论:输尿管镜技术由于其适应于泌尿系统腔道的独特特点,可应用于泌尿外科的许多疾病的诊治,尤其对输尿管下段结石可作为首选治疗措施;只要仔细操作,随着经验的积累,并发症发生率会越来越低。

    Release date:2016-09-08 10:02 Export PDF Favorites Scan
  • Clinical Analysis of Treating Ureteral Calculus with Ureteroscopic Pneumatic Lithotripsy by Ultraobservation

    目的:探讨B超监测下输尿管镜治疗输尿管结石的临床疗效及可行性。方法:2007年12月~2008年12月采用B超监测下输尿管镜治疗输尿管结石患者34例,结石位于上段4例,中段11例,下段19例。结果:一次性碎石治愈者33例,一次性碎石成功率97%,手术时间(40±15)min,术后2~7天排尽结石,术后住院平均时间3.5(2~5)天。结论:B超监测下输尿管镜治疗输尿管结石对于手术操作者易于随时动态观察结石情况,对于大于0.4 cm的碎石块无遗漏,增加术中一次碎石成功率,可行性高。

    Release date:2016-09-08 09:56 Export PDF Favorites Scan
  • 双输尿管镜下尿道会师术治疗男性尿道损伤

    目的 总结双输尿管镜下尿道会师术治疗男性尿道损伤的疗效和安全性。 方法 回顾性分析2006年7月-2010年10月24例经双输尿管镜下尿道会师术治疗的男性尿道损伤患者的临床资料。观察手术时间、术后排尿通畅情况、尿流率及是否并发尿道狭窄、尿瘘、尿失禁和阴茎勃起功能障碍。 结果 球部损伤患者16例会师成功,后尿道损伤患者6例会师成功,2例失败。手术时间20~35 min,平均28 min。术后均常规尿道扩张。2例并发严重尿道狭窄,行尿道狭窄内切开术,疗效佳。随访1年时行尿流率检测,最大尿流率18~25 mL/s,平均22 mL/s。无尿瘘、尿失禁和阴茎勃起功能障碍。。 结论 双输尿管镜尿道会师术疗效确切、安全、操作简单,手术时间短,微创和并发症少。

    Release date:2016-09-08 09:13 Export PDF Favorites Scan
  • Effectiveness and Safety of Ureteroscopy Surgery in Treatment of Upper Ureteral Calculi: A Meta-Analysis

    ObjectiveTo systematically review the effectiveness and safety of transurethral ureteroscopy lithotripsy in the treatment of upper ureteral calculi. MethodsWe electronically searched The Cochrane Library (Issue 3, 2013), PubMed (1966 to 2013.8), EMbase (1990 to 2013.8), CNKI (1949 to 2013.9), CBM (1978 to 2013.9), VIP (1989 to 2013.8) and WanFang Data (1990 to 2013.8) for the randomized controlled studies (RCTs) related to retroperitoneoscopy ureterolithotomy versus transurethral ureteroscopy lithotripsy for upper ureteral calculi. Two reviewers independently screened literature, extracted data, and evaluated methodological quality of included studies. Then meta-analysis was performed using RevMan 5.2 software. ResultsA total of 16 RCTs involving 1 410 patients (transurethral ureteroscopy lithotripsy:747 cases; etroperitoneal laparoscopic ureterolithotomy:663 cases) were included. The results of meta-analysis showed that, transurethral ureteroscopy lithotripsy was lower than retroperitoneoscopy ureterolithotomy in success rates of surgery (OR=0.26, 95%CI 0.14 to 0.51), 3-day stone clearance rates (OR=0.06, 95%CI 0.03 to 0.11), and 1-month stone clearance rates (OR=0.21, 95%CI 0.08 to 0.53), while it showed superiority in operation time (MD=-22.35, 95%CI-35.29 to-9.41) and postoperative hospital stay (MD=-1.84, 95%CI-3.44 to-0.24). ConclusionCurrent evidence shows that, in the treatment of upper ureteral calculi, transurethral ureteroscopy lithotripsy causes less operation time and postoperative hospital stay, but it had no advantage in success rates of surgery, 3-day stone clearance rates, and 1-month stone clearance rates.

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  • 输尿管镜下气压弹道碎石治疗输尿管上段结石

    【摘要】 目的 总结输尿管镜下气压弹道碎石技术治疗输尿管上段结石的疗效。 方法 回顾性分析2004年1月-2010年2月,采用输尿管镜下气压弹道碎石技术治疗106例输尿管结石患者的临床资料。其中男68例,女38例;年龄17~72岁,平均44岁。病程3 d~6个月,平均45 d。结石直径8.0~25.0 mm,平均16.5 mm。 结果 一次性碎石成功89例(84%)。碎石过程中有52例(49%)结石移位至肾盂内,其中37例在肾上盏内予以成功碎石;15例结石停留在肾中、下盏,留置输尿管支架管后二期行体外冲击波碎石(extracorporeal shock wave lithotripsy,ESWL)碎石。2例因输尿管扭曲或狭窄改行输尿管切开取石;余104例术后1~3个月KUB加IVU检查98例结石排尽,积水消失或明显减轻。 结论 通过熟练的输尿管镜碎石技术、适当的体位和灌注、合适的碎石方式、术后ESWL治疗等,输尿管镜下气压弹道碎石术是治疗输尿管上段结石的有效方法。

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  • 经电切镜外鞘输尿管镜气压弹道碎石术治疗下尿路结石

    【摘要】 目的 总结经电切镜外鞘输尿管镜气压弹道碎石术治疗下尿路结石的疗效。 方法 2009年10月-2010年4月,采用经电切镜外鞘输尿管镜直达结石部位,采用气压弹道碎石术治疗下尿路结石20例。其中男15例,女5例;年龄35~80岁,平均54岁。膀胱结石18例,后尿道(尿道膜部)结石2例,结石直径0.5~2.0 cm,均为单发。病程6 h~2年,平均15 d。 结果 20例均一次性成功碎石,碎石成功率100%。碎石时间15~45 min,平均27 min;术后住院时间2~6 d,平均3.7 d。术后无大出血、水中毒、感染等术后早期并发症。13例患者获随访,随访时间1~3个月,平均1.2个月。所有患者均未出现结石复发、尿道狭窄等并发症。 结论 经电切镜外鞘输尿管镜下气压弹道碎石术治疗下尿路结石疗效确切、微创,是一种治疗下尿路结石的安全方法。

    Release date:2016-09-08 09:26 Export PDF Favorites Scan
  • Cooperation in Ureteroscopic Procedures in Treatment of Pyonephrosis Caused by Ureteral Stone Obstruction

    目的 总结应用输尿管镜治疗结石梗阻性肾积脓手术配合的经验。 方法 对2003年4月-2007年12月因输尿管结石引起梗阻性肾积脓的27例患者行输尿管镜检查、气压弹道碎石、取石及留置双J管治疗的临床资料及手术配合进行回顾性分析。 结果 27例患者中,1次取净结石24例;术后2周经体外震波碎石治愈2例;改行开放手术1例,术中无明显并发症。 结论 手术护士应熟悉操作步骤,密切配合医生手术。应用输尿管镜治疗结石梗阻性肾积脓具有疗效好、创伤小、安全可靠等优点。

    Release date:2016-09-08 09:49 Export PDF Favorites Scan
  • 医护合作-快速康复模式在经输尿管镜钬激光碎石术中的应用及效果评价

    目的 探讨医护合作-快速康复模式在经输尿管镜钬激光碎石手术中的临床应用及效果的评价。 方法 将 2015 年 10 月—2016 年 3 月入住的 166 例输尿管结石患者随机分为对照组和试验组各 83 例,对照组按传统方法进行住院治疗及围手术期护理,试验组按照医护合作-快速康复模式进行诊治及护理,包括门诊评估、术前检查的完善、麻醉评估、流程办理、家庭护理的注意事项、围手术期的饮食活动指导和疼痛管理、健康保健等。比较两组患者的住院时间、住院费用、术后并发症、术后首次进食时间和满意度的差异。 结果 试验组患者住院时间[(22.46±0.89)h]少于对照组[(76.46±0.75)h],住院费用[(8 275.21±789.45)元]低于对照组[(12 859.11±1 047.54)元],并发症发生率[10.8%(9/83)]低于对照组[41.0%(34/83)],患者满意度[(99.87±5.12)%]高于对照组[90.66±5.95)%],差异均有统计学意义(P<0.05)。 结论 医护合作-快速康复模式应用于输尿管镜钬激光碎石手术,能充分利用医疗资源,促进医患关系协调,缩短患者的住院日,减少患者的住院费用,降低术后并发症的发生,促进术后康复,早日恢复患者的正常生活。

    Release date:2017-12-25 06:02 Export PDF Favorites Scan
  • A Meta-analysis of Percutaneous Nephrolithotomy versus Ureterolithotripsy in the Treatment of Impacted Proximal Ureteral Stones >1 cm

    ObjectiveTo assess the efficacy and safety of percutaneous nephrolithotomy (PCNL) versus ureteroscopic lithotripsy (URL) in the treatment of impacted proximal ureteral stones>1 cm. MethodsWe electronically searched PubMed, Cochrane library, Embase, WanFang, Chinese National Knowledge Infrastructure and VIP database (by the end of July 2015) to collect randomized controlled trials involving PCNL vs. URL for the treatment of impacted proximal ureteral stones> 1 cm. The quality of those trials were assessed. Data were extracted and analyzed with RevMan 5.3 software. ResultsSix randomized controlled trials were finally obtained after screening. A total of 487 patients were included for a Meta-analysis. The results showed that, as compared with the control group (URL), the patients in the trial group (PCNL) had the following features: ① There was a remarkable improvement of stone clearance rate [RR=1.20, 95% CI (1.09, 1.33), P=0.000 3].② There was no statistical difference in postoperative fever rates, urinary tract perforation rates [RR=1.73, 95%CI (0.43, 7.00), P=0.45; RR=1.02, 95%CI (0.11, 9.37), P=0.99], but the incidence of hematuria was higher [RR=1.99, 95%CI (1.09, 3.62), P=0.03], and the mean operative duration was longer [WMD=30.03 minutes, 95%CI (10.04, 50.02) minuntes, P=0.003].③ The mean hospitalization stay was delayed by an average of 3.73 days [WMD=3.73 days, 95%CI (3.02, 4.44) days, P<0.000 01]. ConclusionPCNL is better than URL in the stone clearance rate, while patients in the PCNL group have to stay in the hospital much longer, and should bear longer mean operative duration.

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  • 微通道经皮肾输尿管镜联合气压弹道碎石术在基层医院的应用分析

    目的探讨微通道经皮肾输尿管镜联合气压弹道碎石取石术(mini-PCNL)在基层医院的应用疗效和安全性。 方法对2010年3月-2013年3月收治的108例上尿路结石患者采用mini-PCNL予以治疗,并就手术方式、手术时间、结石清除率等情况进行分析表述。 结果107例患者成功在B型超声引导下建立经皮肾穿刺通道,1例肾下盏结石因肾脏大出血改开放手术行肾部分切除术,3例患者术中建立通道后出血较多安置肾造瘘管后行二期手术。手术时间为20~190 min,平均(78.0±40.1)min,结石总清除率78.5%,其中输尿管上段结石单次清除率100.0%、肾结石单次清除率70.1%。术中平均出血量(105.0±45.6)mL,无胸膜、腹腔脏器、结肠损伤;平均住院7~14 d。 结论mini-PCNL治疗上尿路结石具有较高的结石清除率、良好的安全性,同时具有术后恢复快、费用适中等优点,值得在基层医院推广应用。

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